Individual
KATELYN HAYWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1700 NE 102ND AVE, PORTLAND, OR 97220-3804
(971) 229-6768
Mailing address
5717 NE 138TH AVE, PORTLAND, OR 97230-3409
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0013672
OR
183500000X
Pharmacist
60385322
WA
Other
Enumeration date
09/30/2015
Last updated
09/30/2015
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