Individual
PENNY JUDALENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4855 SW WESTERN AVE, BEAVERTON, OR 97005-3460
(503) 350-3128
(503) 626-4149
Mailing address
4855 SW WESTERN AVE, BEAVERTON, OR 97005-3460
(503) 350-3128
(503) 626-4149
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RPH-0009688
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
9688
OR
Other
Enumeration date
09/08/2016
Last updated
12/08/2019
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