Individual
MR. WALTER JAMES LEATHERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1700 E 19TH ST, THE DALLES, OR 97058-3317
(541) 296-7526
(541) 296-7616
Mailing address
43005 E LARCH MOUNTAIN RD, CORBETT, OR 97019-8776
(503) 695-5103
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6732
OR
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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