Individual
DUANE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
3987 SE WEIGEL ST, CORVALLIS, OR 97330-3569
(541) 745-8107
Mailing address
3987 SE WEIGEL ST, CORVALLIS, OR 97330-3569
(541) 745-8107
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
013278
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
013278
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265782379
—
OR
01
—
RPH-0013278
OREGON BOARD OF PHARMACY
OR
Enumeration date
09/17/2012
Last updated
07/28/2022
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