Individual
DR. BENJAMIN UPHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
90 B AVE, LAKE OSWEGO, OR 97034-3131
(503) 697-0990
Mailing address
6426 N PRINCETON ST APT 4, PORTLAND, OR 97203-4051
(404) 693-2727
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-001691-
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH-0116911
OREGON BOARD OF PHARMACY
OR
Enumeration date
10/14/2018
Last updated
10/14/2018
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