Individual
BRIAN WADYKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
1950 NE BURNSIDE RD, GRESHAM, OR 97030-7949
(503) 674-8482
Mailing address
315 NE 52ND AVE, PORTLAND, OR 97213-3011
(972) 655-9000
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0011097
OR
Other
Enumeration date
11/22/2010
Last updated
11/22/2010
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