ANTHONY F. DEFAZIO

PORTLAND, OR
NPI1750654968
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy183500000X Pharmacist
(Licence: OR  RPH-0005733)
Enumeration Date2012-02-17
Last Update Date2012-02-17
Business Address
-- ANTHONY F. DEFAZIO RPH
17108 SE POWELL BLVD
PORTLAND, OR 97236-1753
Phone number: 503-667-5377
Mailing Address
-- ANTHONY F. DEFAZIO RPH
17108 SE POWELL BLVD
PORTLAND, OR 97236-1753
Phone number: 503-667-5377