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Individual

MICHAEL SEAN PHELPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPHT

Contact information

Practice address
12360 E BURNSIDE ST, PORTLAND, OR 97233-1042
(971) 279-4800
(971) 279-2763
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
CPT-0009066
OR
183700000X
Pharmacy Technician
VA60433526
WA

Other

Enumeration date
10/03/2022
Last updated
10/03/2022
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