Individual
PATRICIA M PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
8145 SW BARBUR BLVD, PORTLAND, OR 97219-2849
(503) 892-4975
Mailing address
8145 SW BARBUR BLVD, PORTLAND, OR 97219-2849
(503) 892-4975
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10784
OR
Other
Enumeration date
12/02/2010
Last updated
12/02/2010
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