Individual
MIKHALA E WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
16300 SE EVELYN ST, CLACKAMAS, OR 97015-9515
(406) 360-2233
Mailing address
2970 LONGFELLOW PL APT 564, EUGENE, OR 97408-7473
(406) 360-2233
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0016140
OR
Other
Enumeration date
06/27/2017
Last updated
09/05/2017
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