Individual
KYLE OCHOTNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7600 SW DARTMOUTH ST, TIGARD, OR 97223-8181
(503) 268-5272
Mailing address
4405 SW CONDOR AVE, PORTLAND, OR 97239-4008
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2020036160
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2020036160
MISSOURI PHARMACIST LICENSE
MO
01
—
RPH-0020507
OREGON PHARMACIST LICENSE
OR
Enumeration date
12/03/2020
Last updated
08/26/2025
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