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1043217961
WILLIAM FRED BROUSSARD
PORTLAND, OR
NPI
1043217961
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: OR 6521)
Enumeration Date
2005-07-07
Last Update Date
2007-07-08
Business Address
Mr. WILLIAM FRED BROUSSARD RPh
5415 SW BEAVERTON HILLSDALE HWY
PORTLAND, OR 97221-1918
Phone number: 503-246-5077
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Mailing Address
Mr. WILLIAM FRED BROUSSARD RPh
15924 SW BRECCIA DR
BEAVERTON, OR 97007-8567
Phone number: 503-524-9011
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