Individual
BLAKE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
8979 NE TENNYSON ST APT 316, HILLSBORO, OR 97006-2927
(760) 672-9986
Mailing address
8979 NE TENNYSON ST APT 316, HILLSBORO, OR 97006-2927
(760) 672-9986
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0019356
OR
Other
Enumeration date
03/23/2023
Last updated
03/23/2023
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