Individual
BRIANNA WANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14700 SE DIVISION ST, PORTLAND, OR 97236-2335
(503) 762-4436
Mailing address
14700 SE DIVISION ST, PORTLAND, OR 97236-2335
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RPH0014960
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RPH-0014960
OR
390200000X
Student in an Organized Health Care Education/Training Program
PI-0011226
OR
Other
Enumeration date
07/28/2013
Last updated
06/19/2017
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