Individual
MICHAEL KISO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD, RPH
Contact information
Practice address
4560 SE INTERNATIONAL WAY STE 101, PORTLAND, OR 97222-4628
(971) 206-5205
Mailing address
4560 SE INTERNATIONAL WAY STE 101, PORTLAND, OR 97222-4628
(971) 206-5205
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0016263
OR
Other
Enumeration date
07/06/2018
Last updated
07/06/2018
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