Individual
JEFFERY BRADFORD YATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1555 NE DIVISION ST, GRESHAM, OR 97030-4271
(503) 666-9476
Mailing address
2201 NE 61ST AVE, PORTLAND, OR 97213-4147
(503) 949-4325
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PI-0010493
OR
Other
Enumeration date
08/05/2010
Last updated
08/05/2010
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