Individual
THIPPHACHANH PITSNUKANH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
13 NW 23RD PL, PORTLAND, OR 97210-3534
(503) 226-6211
Mailing address
1907 SE 162ND AVE, PORTLAND, OR 97233-4103
(503) 679-6871
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0018686
OR
Other
Enumeration date
11/12/2021
Last updated
11/12/2021
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