| NPI | 1700972759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN DWIGHT QUISENBERRY Pharmacist Owner 503-364-3336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: OR RP-0000534-CS) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-08-22 |