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Individual

DAVID ALLAN SCHULBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.PH.

Contact information

Practice address
514 W MAIN ST, MOLALLA, OR 97038-9260
(503) 829-4555
(503) 829-4494
Mailing address
514 W MAIN ST, MOLALLA, OR 97038-9260
(503) 829-4555
(503) 829-4494

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6105
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6105
STATE PHARMACIST LICENSE
OR
Enumeration date
02/10/2012
Last updated
02/10/2012
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