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Individual

JASEN KARL KNUDSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Contact information

Practice address
5717 NE 138TH AVE, PORTLAND, OR 97230-3409
(503) 261-2053
(503) 261-7978
Mailing address
4714 NE 72ND AVE APT 33, VANCOUVER, WA 98661-8114
(360) 606-1456

Taxonomy

Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
PH00060941
WA
1835P1200X
Pharmacotherapy Pharmacist
Primary
RPH-0010684
OR

Other

Enumeration date
08/25/2006
Last updated
07/08/2007
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