Individual
JUSTIN TADINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH
Contact information
Practice address
12080 SW MAIN ST, TIGARD, OR 97223-6218
(503) 620-9322
Mailing address
12080 SW MAIN ST, TIGARD, OR 97223-6218
(503) 620-9322
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0013973
OR
Other
Enumeration date
04/17/2014
Last updated
04/17/2014
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