Individual
MAYASAH ANAS SEDEEQ AL BAZZAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15122 NW FIG LN, PORTLAND, OR 97229-6986
(971) 340-6940
Mailing address
15122 NW FIG LN, PORTLAND, OR 97229-6986
(971) 340-6940
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0017782
OR
Other
Enumeration date
02/26/2020
Last updated
02/26/2020
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