Individual
KAYA LEVESQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1620 NE GRAND AVE, PORTLAND, OR 97232-1149
(503) 493-2715
Mailing address
1620 NE GRAND AVE, PORTLAND, OR 97232-1149
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0010519
OR
Other
Enumeration date
05/27/2010
Last updated
05/27/2010
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