Individual
BRAD HALVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
5717 NE 138TH AVE, PORTLAND, OR 97230-3409
(503) 261-7981
Mailing address
5717 NE 138TH AVE, PORTLAND, OR 97230-3409
(503) 261-7981
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7468
OR
Other
Enumeration date
06/29/2016
Last updated
06/29/2016
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