Individual
DR. CODY SORENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3098
(503) 494-8311
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
3920
WY
183500000X
Pharmacist
PHA-PHA-LIC-25445
MT
183500000X
Pharmacist
Primary
RPH-0015174
OR
Other
Enumeration date
11/30/2021
Last updated
11/30/2021
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