Individual
MOHAMMAD REZA SASAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
19200 SW MARTINAZZI AVE, TUALATIN, OR 97062-6357
(503) 691-4233
(503) 691-4220
Mailing address
19200 SW MARTINAZZI AVE, TUALATIN, OR 97062-6357
(503) 691-4233
(503) 691-4220
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
13388
OR
183500000X
Pharmacist
35947
TX
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
0013388
OR
Other
Enumeration date
10/17/2013
Last updated
05/03/2017
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