Individual
DR. CONNIE CHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
16300 SE EVELYN ST, CLACKAMAS, OR 97015-9515
(503) 305-9700
Mailing address
16300 SE EVELYN ST, CLACKAMAS, OR 97015-9515
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0015564
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015564
PHARMD
OR
Enumeration date
08/30/2016
Last updated
11/22/2017
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