Individual
MR. KIRK THOMAS GATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12065 SW WALNUT ST, TIGARD, OR 97223-3033
(360) 790-2293
Mailing address
12065 SW WALNUT ST, TIGARD, OR 97223-3033
(360) 790-2293
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
T-0011752
OR
183700000X
Pharmacy Technician
VA00057147
WA
Other
Enumeration date
04/11/2008
Last updated
04/11/2008
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