Individual
GRACHELLE GONONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7411 NE 117TH AVE, VANCOUVER, WA 98662-4706
(360) 896-3533
Mailing address
3800 SE 22ND AVE, PORTLAND, OR 97202-2918
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0019298
OR
183500000X
Pharmacist
Primary
61351039
WA
Other
Enumeration date
11/25/2022
Last updated
12/09/2022
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