Individual
LYNN MARIE NISHIDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
11494 SE RIMROCK DR, HAPPY VALLEY, OR 97086-7154
(971) 242-9973
Mailing address
11494 SE RIMROCK DR, HAPPY VALLEY, OR 97086-7154
(971) 242-9973
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7580
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7580
COMMERCIAL
OR
Enumeration date
06/27/2019
Last updated
06/27/2019
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