Individual
MEGAN KHAMSOUKTHAVONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH, PHARMD
Contact information
Practice address
4346 NE CULLY BLVD, PORTLAND, OR 97218-2206
(503) 288-0836
Mailing address
4346 NE CULLY BLVD, PORTLAND, OR 97218-2206
(503) 288-0836
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0019349
OR
Other
Enumeration date
03/29/2023
Last updated
03/29/2023
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