Individual
GARY BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD, RPH
Contact information
Practice address
2801 ST ANTHONY WAY, PENDLETON, OR 97801-3800
(541) 276-5121
Mailing address
2801 ST ANTHONY WAY, PENDLETON, OR 97801-3800
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
P6220
ID
183500000X
Pharmacist
PH 00062359
WA
183500000X
Pharmacist
Primary
RPH-0010717
OR
Other
Enumeration date
12/13/2014
Last updated
12/13/2014
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