Individual
MR. PATRICK JOHN SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2500 MAIN AVE N, TILLAMOOK, OR 97141-7784
(503) 815-1433
(503) 815-1427
Mailing address
2500 MAIN AVE N, TILLAMOOK, OR 97141-7784
(503) 815-1433
(503) 815-1427
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0010196
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
0010196
OR
Other
Enumeration date
02/21/2012
Last updated
04/26/2017
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