Individual
ANDREW MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5717 NE 138TH AVE, PORTLAND, OR 97230-3409
(503) 261-2050
Mailing address
17285 CHAROLAIS WAY, GLADSTONE, OR 97027-1269
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0016162
OR
Other
Enumeration date
09/01/2017
Last updated
09/01/2017
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