Individual
DUSTIN J CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
4400 NE HALSEY ST STE 490, PORTLAND, OR 97213-1545
(503) 893-6900
(503) 487-3595
Mailing address
8423 SW POINTER WAY APT M, PORTLAND, OR 97225-7316
(541) 301-5735
Taxonomy
Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
RPH-0017464
OR
Other
Enumeration date
07/09/2020
Last updated
07/09/2020
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