Individual
BRIAN KEN IKEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
16100 SW 72ND AVE, PORTLAND, OR 97224-7745
(503) 626-9436
Mailing address
16100 SW 72ND AVE, PORTLAND, OR 97224-7745
(503) 626-9436
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0013697
OR
Other
Enumeration date
11/09/2013
Last updated
12/18/2014
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