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Individual

MARIA STEPHANIE LARA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
891 SE 1ST AVE, CANBY, OR 97013-3811
(503) 266-6381
Mailing address
1050 SW 160TH AVE APT 134, BEAVERTON, OR 97006-5017
(661) 889-0936

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0019419
OR

Other

Enumeration date
04/11/2023
Last updated
04/11/2023
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