Individual
PETE BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
STUDENT
Contact information
Practice address
530 NW 27TH ST, CORVALLIS, OR 97330-5223
(541) 766-6835
Mailing address
1111 SATARA CT NW, SALEM, OR 97304-2811
(206) 229-1085
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PI-0010074
OR
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PI-0010074
OR
Other
Enumeration date
11/02/2010
Last updated
11/02/2010
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