Individual
MR. JOHN H BRUNSCHEON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
1525 W MAIN ST, SAFEWAY PHARMACY #1751, MOLALLA, OR 97038-7362
(503) 829-4855
(503) 829-4780
Mailing address
PO BOX 1042, MULINO, OR 97042-1042
(503) 631-8085
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
6151
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6151
OR BOARD OF PHARMACY LIC
OR
Enumeration date
08/18/2005
Last updated
07/08/2007
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