Individual
XIAO TIAN YAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1904 SW VERMONT ST, PORTLAND, OR 97219-9400
(515) 441-9005
Mailing address
1904 SW VERMONT ST, PORTLAND, OR 97219-9400
(515) 441-9005
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
051293700
IL
183500000X
Pharmacist
1-14904
KS
1835P1200X
Pharmacotherapy Pharmacist
Primary
RPH-0013764
OR
Other
Enumeration date
10/04/2011
Last updated
12/11/2013
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