Individual
MARY NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1642 WILLIAMS HWY, GRANTS PASS, OR 97527-5660
(541) 479-6698
Mailing address
2293 BROMLEY ST APT 4, MEDFORD, OR 97501-7533
(225) 718-8755
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0017482
OR
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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