Individual
JOSHUA PETRISOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7700 SW BEAVERTON HILLSDALE HWY, PORTLAND, OR 97225-2101
(503) 203-4033
Mailing address
17885 SW JAY ST, BEAVERTON, OR 97003-3771
(503) 619-5900
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RPH-0017693
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RPH-0017693
OR
Other
Enumeration date
12/29/2020
Last updated
02/01/2021
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