RYAN AMOS MICKELSON

SALEM, OR
NPI1437480316
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: OR  RPH-0011121)
Additional Taxonomies183500000X Pharmacist
(Licence: WI  15475-040)
1835P1200X Pharmacist, Pharmacotherapy
(Licence: OR  BCPS 308009953)
Enumeration Date2010-01-16
Last Update Date2010-01-16
Business Address
Mr. RYAN AMOS MICKELSON PharmD, BCPS
3750 CHEMAWA RD NE
SALEM, OR 97305-1119
Phone number: 503-304-7600
Mailing Address
Mr. RYAN AMOS MICKELSON PharmD, BCPS
245 SW HOOKER ST APT 1
PORTLAND, OR 97201-4774
Phone number: 608-212-9204