Individual
MARK ALLEN BIBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 220-8262
Mailing address
192 SE ANDERSON LN, GRESHAM, OR 97080-1997
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
3195
MT
Other
Enumeration date
08/10/2006
Last updated
02/13/2008
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