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1841777240
MANORAK CHANTHAVONG
PORTLAND, OR
NPI
1841777240
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: OR 9171)
Enumeration Date
2018-07-27
Last Update Date
2018-07-27
Business Address
MANORAK CHANTHAVONG
5717 NE 138TH AVE
PORTLAND, OR 97230-3499
Phone number: 503-261-7547
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Mailing Address
MANORAK CHANTHAVONG
5717 NE 138TH AVE
PORTLAND, OR 97230-3499
Phone number:
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