Individual
MR. DWIGHT JOHN MATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3250 LEIF ERIKSON DR, ASTORIA, OR 97103-2637
(503) 338-0291
Mailing address
3250 LEIF ERIKSON DR, ASTORIA, OR 97103-2637
(503) 338-0291
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0005128
OR
Other
Enumeration date
05/04/2012
Last updated
05/04/2012
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