Individual
MR. MARK W KASHISHIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
506 E MAIN ST, ROGUE RIVER, OR 97537-9615
(541) 582-0559
(541) 582-3045
Mailing address
PO BOX 700, ROGUE RIVER, OR 97537-0700
(541) 582-0559
(541) 582-3045
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0008241
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH-0008241
PHARMACIST LICENSE
OR
01
—
RPH-0008241-P
PHARMACY PRECEPTOR LICENSE
OR
Enumeration date
03/25/2013
Last updated
03/25/2013
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