Individual
KEVIN HILLEGASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6116 NE MLK BLVD, PORTLAND, OR 97211-3159
(503) 282-0689
(503) 282-0809
Mailing address
6116 NE MLK BLVD, PORTLAND, OR 97211-3159
(503) 282-0689
(503) 282-0809
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0010008
OR
Other
Enumeration date
09/10/2009
Last updated
09/10/2009
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