Individual
TREVOR CHARLES ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3043 NE 28TH ST, LINCOLN CITY, OR 97367-4518
(541) 996-7375
Mailing address
6215 SW CORBETT AVE, PORTLAND, OR 97239-3603
Taxonomy
Speciality
Code
Description
License number
State
1835C0205X
Critical Care Pharmacist
Primary
RPH-0017544
OR
390200000X
Student in an Organized Health Care Education/Training Program
P2-0012323
OR
Other
Enumeration date
03/02/2018
Last updated
07/28/2022
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