Individual
JILL E ROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
4805 NE GLISAN ST, PORTLAND, OR 97213-2933
(503) 215-1111
Mailing address
4911 SW 1ST AVE, PORTLAND, OR 97239-2883
(765) 914-3893
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0011896
OR
Other
Enumeration date
09/09/2009
Last updated
09/09/2009
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