Individual
MIKE MALACHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
16300 SE EVELYN ST, CLACKAMAS, OR 97015-9515
(503) 656-1461
Mailing address
12800 NE 4TH ST APT LL116, VANCOUVER, WA 98684-7007
(808) 282-1477
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0016191
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RPH-0016191
—
OR
Enumeration date
09/14/2017
Last updated
09/14/2017
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