Individual
EILEEN H PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2836 PACIFIC AVE, FOREST GROVE, OR 97116-1896
(503) 359-8706
Mailing address
2836 PACIFIC AVE, FOREST GROVE, OR 97116-1896
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0013305
OR
Other
Enumeration date
08/07/2012
Last updated
10/04/2012
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