Individual
EKDARA SIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
11863 SW GREENBURG RD APT 5, TIGARD, OR 97223-6493
(541) 281-9070
Mailing address
11863 SW GREENBURG RD APT 5, TIGARD, OR 97223-6493
(541) 281-9070
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0014964
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH-0014964
PHARMACY LICENSE
OR
Enumeration date
09/26/2015
Last updated
09/26/2015
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