Individual
JESSE PARIS GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11190 SW BARNES RD, PORTLAND, OR 97225-5372
(503) 528-9121
(503) 628-4802
Mailing address
11190 SW BARNES RD, PORTLAND, OR 97225-5372
(503) 528-9121
(503) 628-4802
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
0011735
OR
Other
Enumeration date
04/28/2023
Last updated
04/28/2023
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