Individual
JORDAN CARL STOOKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
5253 SE 82ND AVE STE 27, PORTLAND, OR 97266-4885
(503) 477-8453
(503) 477-8416
Mailing address
1825 NW 143RD AVE APT C22, PORTLAND, OR 97229-8129
(541) 733-5697
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0020354
OR
Other
Enumeration date
12/28/2024
Last updated
12/28/2024
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