| NPI | 1518444025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN LANG Owner 503-705-4105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2018-07-26 |