Individual
MR. BRAD CRAIG BOEHME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9775 SW GEMINI DR, STE 1, BEAVERTON, OR 97008-7148
(866) 202-4014
Mailing address
9775 SW GEMINI DR, STE 1, BEAVERTON, OR 97008-7148
(866) 202-4014
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0008601
OR
183500000X
Pharmacist
13142
NE
183500000X
Pharmacist
47988
TX
183500000X
Pharmacist
S015044
AZ
Other
Enumeration date
04/22/2014
Last updated
04/22/2014
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