Individual
CRYSTAL BANAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
14700 SE DIVISION ST, PORTLAND, OR 97236-2335
(503) 762-4436
Mailing address
60888 NE GWEN AVE, CASCADE LOCKS, OR 97014-6628
(503) 729-1922
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PI-0013306
OR
Other
Enumeration date
10/17/2022
Last updated
10/17/2022
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