| NPI | 1033482385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA HYSEN Pharmacy Mgr 503-802-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0002X Pharmacy Mail Order Pharmacy (Licence: OR RP-0002429-CS) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2012-02-17 |
| Last Update Date | 2018-07-27 |