Individual
MR. WILLIS EUGENE CARMEN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
3527 SE 122ND AVE, PORTLAND, OR 97236-3401
(503) 760-6688
Mailing address
1128 SW 10TH DR, GRESHAM, OR 97080-9679
(503) 667-6626
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6722
OR
Other
Enumeration date
10/26/2010
Last updated
10/26/2010
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