Individual
JACOB DOUGLAS BURGIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
19200 SW MARTINAZZI AVE, TUALATIN, OR 97062-6357
(503) 691-4233
Mailing address
11671 SW TEAL BLVD APT G, BEAVERTON, OR 97007-8248
(661) 349-5721
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0020309
OR
Other
Enumeration date
11/02/2024
Last updated
11/02/2024
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