Individual
BOUNNHOU BON SIHAVONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
16100 SW 72ND AVE, PORTLAND, OR 97224-7745
(800) 330-3665
Mailing address
PO BOX 230969, PORTLAND, OR 97281-0969
(800) 330-3665
(800) 982-2730
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PH 60504941
WA
183500000X
Pharmacist
Primary
RPH-0014294
OR
Other
Enumeration date
02/10/2015
Last updated
02/10/2015
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