Individual
DR. TABEN MAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD, MS
Contact information
Practice address
3325 N INTERSTATE AVE, PORTLAND, OR 97227-1020
(503) 348-9917
Mailing address
3325 N INTERSTATE AVE, PORTLAND, OR 97227-1020
(503) 348-9917
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
1-15406
KS
183500000X
Pharmacist
Primary
6617221-1701
UT
183500000X
Pharmacist
RPH-0014364
OR
Other
Enumeration date
06/29/2016
Last updated
06/29/2016
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