Individual
DR. JEFFERY DALE FORTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
1125 NE 99TH AVE, PORTLAND, OR 97220-9428
(503) 254-7383
Mailing address
222 SE 8TH AVE, SUITE 451, HILLSBORO, OR 97123-4218
(503) 352-7269
(503) 352-7270
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0010486
OR
Other
Enumeration date
09/28/2011
Last updated
09/28/2011
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