Individual
DR. JASON PENNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
19500 SE STARK ST, PORTLAND, OR 97233-5757
(866) 280-2123
Mailing address
17216 NE 224TH AVE, BRUSH PRAIRIE, WA 98606-8104
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0015645
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
RPH-0015645
OR
Other
Enumeration date
10/11/2016
Last updated
02/21/2020
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