Individual
KENT REGER NIEDENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
3025 LANCASTER DR NE, SALEM, OR 97305-1391
(503) 378-7720
Mailing address
1194 SHIPPING ST NE, SALEM, OR 97301-7817
(406) 579-2065
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PHA-PHA-LIC-71032
MT
183500000X
Pharmacist
Primary
RPH-0017981
OR
Other
Enumeration date
08/05/2020
Last updated
08/05/2020
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