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General NPI Number Information
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NPI Number | 1144523168
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Entity Type | Organization
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Legal Business Name | P BOWMAN LLC
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Dates
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Enumeration Date | 12/13/2010
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Last Update Date | 12/13/2010
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Provider Practice Location Address
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Address Line | 19297 SW MARTINAZZI AVE
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City | TUALATIN
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State | OR
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Zip | 97062-6352
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Country | US
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Telephone | 503-649-5557
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Fax |
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Provider Business Mailing Address
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Address Line | 19297 SW MARTINAZZI AVE
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City | TUALATIN
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State | OR
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Zip | 97062-6352
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Country | US
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Telephone | 503-649-5557
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Fax |
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Authorized Official
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Title or Position | PHARMACIS/OWNER
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Name | MR. PATRICK H BOWMAN
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Credential |
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Telephone | 503-649-5557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 6252
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License Number State | OR
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