Individual
THERESA TAIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25900 SW HEATHER PL, WILSONVILLE, OR 97070-5785
(503) 825-4005
(503) 825-4023
Mailing address
13130 SE 84TH AVE, CLACKAMAS, OR 97015-9733
(503) 794-5520
(503) 794-5528
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0009311
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
0009311
OR
Other
Enumeration date
05/18/2011
Last updated
01/04/2016
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