Individual
CLARICE TATEISHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13485 NW CORNELL RD, PORTLAND, OR 97229-5819
(503) 350-2086
Mailing address
3807 SW ORBIT ST UNIT 304, BEAVERTON, OR 97005-2780
(925) 783-4406
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0019991
OR
Other
Enumeration date
03/26/2024
Last updated
03/26/2024
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