Individual
MR. BURNELL JASON BOEHLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3013 NW STEWART PKWY, ROSEBURG, OR 97471-1612
(541) 957-9236
Mailing address
3013 NW STEWART PKWY, ROSEBURG, OR 97471-1612
(541) 957-9236
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
9895
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RPH-0009895
OR
Other
Enumeration date
10/13/2008
Last updated
02/06/2018
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