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1356461750
JEFFREY A CLARK
PORTLAND, OR
NPI
1356461750
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: OR rph0010544)
Enumeration Date
2007-03-30
Last Update Date
2007-07-08
Business Address
-- JEFFREY A CLARK rph
600 NW 10TH AVE
PORTLAND, OR 97209-3202
Phone number: 503-227-4835
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Mailing Address
-- JEFFREY A CLARK rph
16170 SE GOOSEHOLLOW DR
DAMASCUS, OR 97015-7885
Phone number:
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