Individual
CARL HEISEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH, BCPS
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-4290
Mailing address
5810 SW LURADEL CT, PORTLAND, OR 97219-5780
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
6146
OR
Other
Enumeration date
06/18/2007
Last updated
07/08/2007
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