Individual
SANDY ISAAC BOULES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14700 SE DIVISION ST, PORTLAND, OR 97236-2381
(503) 762-4436
Mailing address
14700 SE DIVISION ST, PORTLAND, OR 97236-2381
(503) 762-4436
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RPH-0020751
OR
Other
Enumeration date
10/14/2025
Last updated
10/14/2025
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