Individual
JEFF RUNDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2131 NEWMARK ST, NORTH BEND, OR 97459-1219
(541) 756-7561
Mailing address
2131 NEWMARK ST, NORTH BEND, OR 97459-1219
(541) 756-7561
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0010505
OR
Other
Enumeration date
02/09/2012
Last updated
02/09/2012
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