Individual
JUSTIN DORMANDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, PORTLAND, OR 97239-2964
(503) 220-8262
Mailing address
1837 SW BINFORD LAKE PKWY, GRESHAM, OR 97080-9795
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
CPT-0001093
OR
Other
Enumeration date
02/04/2007
Last updated
07/08/2007
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