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1003224064
EBISA DERESSA
PORTLAND, OR
NPI
1003224064
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: OR 13751)
Enumeration Date
2014-07-22
Last Update Date
2014-07-22
Business Address
-- EBISA DERESSA
1123 N HAYDEN MEADOWS DR
PORTLAND, OR 97217-7547
Phone number: 503-205-6661
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Mailing Address
-- EBISA DERESSA
1123 N HAYDEN MEADOWS DR
PORTLAND, OR 97217-7547
Phone number: 503-205-6661
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