Individual
TYRELL R GOODRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2280 ASHLAND ST, ASHLAND, OR 97520-1406
(541) 482-8191
Mailing address
2280 ASHLAND ST, ASHLAND, OR 97520-1406
(541) 482-8191
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9230
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH-0009230
PHARMACIST LICENSE
OR
Enumeration date
02/16/2012
Last updated
02/16/2012
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