Individual
MEGAN MOLLY CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
1015 SW BERTHA BLVD APT 2, PORTLAND, OR 97219-2078
(541) 990-6727
Mailing address
1015 SW BERTHA BLVD APT 2, PORTLAND, OR 97219-2078
(541) 990-6727
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PI-0011511
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PI-0011511
PHARMACY LICENSE
OR
Enumeration date
04/12/2016
Last updated
04/12/2016
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