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1750654968
ANTHONY F. DEFAZIO
PORTLAND, OR
NPI
1750654968
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: OR RPH-0005733)
Enumeration Date
2012-02-17
Last Update Date
2012-02-17
Business Address
-- ANTHONY F. DEFAZIO RPH
17108 SE POWELL BLVD
PORTLAND, OR 97236-1753
Phone number: 503-667-5377
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Mailing Address
-- ANTHONY F. DEFAZIO RPH
17108 SE POWELL BLVD
PORTLAND, OR 97236-1753
Phone number: 503-667-5377
Copy
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