Individual
GARY DUANE LUNDGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
538 SW 4TH AVE, PORTLAND, OR 97204-2102
(503) 226-2222
Mailing address
538 SW 4TH AVE, PORTLAND, OR 97204-2102
(503) 226-2222
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0006487
OR
Other
Enumeration date
05/02/2011
Last updated
05/02/2011
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