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Individual

DR. NICOLE NATASIA GUPTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARM D.

Contact information

Practice address
12240 SW SCHOLLS FERRY RD, TIGARD, OR 97223-3354
(503) 590-7346
Mailing address
12240 SW SCHOLLS FERRY RD, TIGARD, OR 97223-3354
(503) 590-7346

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0011808
OR

Other

Enumeration date
08/23/2009
Last updated
08/23/2009
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