Individual
MARY LISA REFAILOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29670 ELLENSBURG AVE, GOLD BEACH, OR 97444-8701
(541) 247-4544
(541) 247-2604
Mailing address
29670 ELLENSBURG AVE, GOLD BEACH, OR 97444-8701
(541) 247-4544
(541) 247-2604
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0017368
OR
Other
Enumeration date
03/29/2022
Last updated
04/05/2022
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