Individual
DR. JEFFREY BIRK COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
700 SE 3RD ST, BEND, OR 97702-1753
(541) 389-9741
Mailing address
700 SE 3RD ST, BEND, OR 97702-1753
(541) 389-9741
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RHP-0011948
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
RPH-0011948
OR
Other
Enumeration date
08/10/2011
Last updated
04/26/2017
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