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Individual

MATTHEW TANNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Contact information

Practice address
890 OAK ST SE, SALEM, OR 97301-3905
(503) 814-2048
Mailing address
890 OAK ST SE, SALEM, OR 97301-3905
(503) 814-2048

Taxonomy

Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
P5672
ID
1835P1200X
Pharmacotherapy Pharmacist
Primary
RPH-0010358
OR

Other

Enumeration date
10/28/2015
Last updated
10/28/2015
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