Individual
LATASHA WALMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4315 SE WOODSTOCK BLVD, PORTLAND, OR 97206-6269
(503) 771-1881
(503) 771-2029
Mailing address
4315 SE WOODSTOCK BLVD, PORTLAND, OR 97206-6269
(503) 771-1881
(503) 771-2029
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
CPT-0001457
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CPT-0001457
STATE PHARMACY TECHNICIAN LICENSE
OR
Enumeration date
02/18/2012
Last updated
02/18/2012
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