Individual
MR. KENNETH RAY WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
16300 SE EVELYN ST, CLACKAMAS, OR 97015-9515
(503) 557-4238
(503) 657-6143
Mailing address
16300 SE EVELYN ST, CLACKAMAS, OR 97015-9515
(503) 557-4238
(503) 657-6143
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5787
OR
Other
Enumeration date
12/26/2007
Last updated
12/26/2007
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