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1780968578
JEFFERY DALE FORTNER
PORTLAND, OR
NPI
1780968578
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: OR RPH-0010486)
Enumeration Date
2011-09-28
Last Update Date
2011-09-28
Business Address
Dr. JEFFERY DALE FORTNER Pharm.D.
1125 NE 99TH AVE
PORTLAND, OR 97220-9428
Phone number: 503-254-7383
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Mailing Address
Dr. JEFFERY DALE FORTNER Pharm.D.
222 SE 8TH AVE SUITE 451
HILLSBORO, OR 97123-4218
Phone number: 503-352-7269
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