Individual
TERRY MAC GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
16100 SW 72ND AVE, PORTLAND, OR 97224-7745
(503) 372-1700
Mailing address
16100 SW 72ND, PORTLAND, OR 97224
(503) 372-1700
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
14617
WA
1835G0303X
Geriatric Pharmacist
Primary
5396
OR
Other
Enumeration date
01/07/2010
Last updated
01/07/2010
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