Individual
GRANT HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16300 SE EVELYN ST, CLACKAMAS, OR 97015-9515
(503) 557-6272
Mailing address
16300 SE EVELYN ST, CLACKAMAS, OR 97015-9515
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5661
OR
Other
Enumeration date
03/14/2012
Last updated
03/14/2012
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