Individual
SUSAN GOHLKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
16300 SE EVELYN ST, CLACKAMAS, OR 97015-9515
(503) 657-8653
Mailing address
22584 SW SAUNDERS DR, SHERWOOD, OR 97140-8251
(503) 925-8849
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6079
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6079
PHARMACY LICENSE
OR
Enumeration date
11/04/2010
Last updated
11/04/2010
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