Individual
BRADEN JEFFREY ENFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2080 NW 9TH ST, CORVALLIS, OR 97330-1484
(541) 753-2226
(541) 753-2559
Mailing address
2080 NW 9TH ST, CORVALLIS, OR 97330-1484
(541) 753-2226
(541) 753-2559
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0017381
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH-0017381
STATE RPH LICENSE
OR
Enumeration date
08/16/2019
Last updated
08/16/2019
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