Individual
KENNETH DUONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15995 SW WALKER RD, BEAVERTON, OR 97006-4910
(503) 690-5833
Mailing address
4774 N GIRARD ST, PORTLAND, OR 97203-4634
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0016925
OR
Other
Enumeration date
10/10/2018
Last updated
10/10/2018
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