Individual
PAM SEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
7080 SW SHADY CT, PORTLAND, OR 97223-1154
(503) 452-0286
Mailing address
7080 SW SHADY CT, PORTLAND, OR 97223-1154
(503) 452-0286
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7405
OR
Other
Enumeration date
07/27/2006
Last updated
07/08/2007
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