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1104476225
ROGER KEVIN CLARK
PORTLAND, OR
NPI
1104476225
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: OR 0011422)
Enumeration Date
2019-09-19
Last Update Date
2019-09-19
Business Address
Dr. ROGER KEVIN CLARK PharmD
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3011
Phone number: 503-418-3308
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Mailing Address
Dr. ROGER KEVIN CLARK PharmD
31192 SW WILLAMETTE WAY W
WILSONVILLE, OR 97070-8581
Phone number: 503-570-3436
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