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Individual

THAI LAC KHUU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARM D

Contact information

Practice address
5253 SE 82ND AVE, PORTLAND, OR 97266-4862
(503) 788-2885
Mailing address
17005 SE SUNNYSIDE RD, HAPPY VALLEY, OR 97015-8724
(971) 999-6284

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0011861
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
RPH-0011861
OR

Other

Enumeration date
01/04/2013
Last updated
04/25/2017
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