Individual
DR. BENJAMIN EUGENE JAQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D, RPH
Contact information
Practice address
18040 SW LOWER BOONES FERRY RD STE 104, TIGARD, OR 97224-7259
(503) 216-0626
(503) 216-0630
Mailing address
18040 SW LOWER BOONES FERRY RD STE 104, TIGARD, OR 97224-7259
(503) 216-0626
(503) 216-0630
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0012721
OR
Other
Enumeration date
10/21/2011
Last updated
10/21/2011
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