Individual
MR. RAYMOND PAUL MICCICHE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
14600 SW MURRAY SCHOLLS DR STE 201, BEAVERTON, OR 97007-9712
(503) 579-1878
(503) 579-0988
Mailing address
14600 SW MURRAY SCHOLLS DR STE 201, BEAVERTON, OR 97007-9712
(503) 579-1878
(503) 579-0988
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9147
OR
Other
Enumeration date
08/27/2010
Last updated
08/27/2010
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