Individual
DR. CHARLES WHITNEY BODREAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
20233 SW JAY ST, ALOHA, OR 97003-8137
(971) 221-8200
Mailing address
20233 SW JAY ST, ALOHA, OR 97003-8137
(971) 221-8200
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0016852
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
0016852
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
021408
KY
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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