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Individual

KEITH DAUGHERTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
20120 PINEBROOK BLVD, BEND, OR 97702-2537
(541) 389-5440
Mailing address
60951 SE SWEET PEA DR, BEND, OR 97702-9759
(541) 912-1245

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7178
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
7178
OR

Other

Enumeration date
11/11/2010
Last updated
04/11/2018
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