Individual
JESSA LULICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
16300 SE EVELYN ST, CLACKAMAS, OR 97015-9515
(503) 305-9700
Mailing address
1226 SW HUME ST, PORTLAND, OR 97219-4349
(503) 764-7578
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0018175
OR
Other
Enumeration date
01/11/2021
Last updated
03/18/2022
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