Individual
MRS. JOHANNA HALEEMA ETHEL KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD, MD
Contact information
Practice address
6390 SW 90TH AVE, PORTLAND, OR 97223-7217
(503) 803-9907
Mailing address
6390 SW 90TH AVE, PORTLAND, OR 97223-7217
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7301
OR
183500000X
Pharmacist
RPH38505
CA
Other
Enumeration date
10/16/2006
Last updated
07/08/2007
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