Individual
CHAMNAN ING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4750 SW WESTERN AVE, BEAVERTON, OR 97005-3431
(503) 626-4710
(503) 626-0590
Mailing address
4750 SW WESTERN AVE, BEAVERTON, OR 97005-3431
(503) 626-4710
(503) 626-0590
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0010478
OR
Other
Enumeration date
02/10/2012
Last updated
02/10/2012
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