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Individual

PHILLIP CORRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
916 EAST EVERGREEN BLVD, PORTLAND, OR 97231
(503) 647-8106
Mailing address
916 EAST EVERGREEN BLVD, PORTLAND, OR 97231

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0007140
OR

Other

Enumeration date
08/13/2021
Last updated
08/13/2021
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