| NPI | 1750554622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN DWIGHT QUISENBERRY President 503-364-3336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: OR 2122) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2008-04-10 |