AMMATA VONGSOUVANH

BEAVERTON, OR
NPI1609112234
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: OR  0011789)
Additional Taxonomies1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
(Licence: OR  rph-0011789)
Enumeration Date2012-12-31
Last Update Date2017-04-26
Business Address
-- AMMATA VONGSOUVANH Pharm. D
15995 SW WALKER RD
BEAVERTON, OR 97006-4910
Phone number: 503-690-5833
Mailing Address
-- AMMATA VONGSOUVANH Pharm. D
15995 SW WALKER RD
BEAVERTON, OR 97006-4910
Phone number: 503-690-5833