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Individual

DR. CAMILLE TACKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD.

Contact information

Practice address
3500 SE 26TH AVE, PORTLAND, OR 97202-2901
(503) 797-2156
Mailing address
PO BOX 2718, PORTLAND, OR 97208-2718
(503) 797-2156

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
S013265
AZ
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RPH-0013489
OR

Other

Enumeration date
10/05/2009
Last updated
10/16/2020
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