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General NPI Number Information
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NPI Number | 1184225351
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Entity Type | Individual
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Provider Name | PATRICK JAMES BROWN
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Gender | Male
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Dates
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Enumeration Date | 11/04/2020
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 6465 KEIZER STATION BLVD NE
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City | KEIZER
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State | OR
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Zip | 97303-1695
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Country | US
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Telephone | 503-856-0614
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Fax |
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Provider Business Mailing Address
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Address Line | 6465 KEIZER STATION BLVD NE
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City | KEIZER
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State | OR
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Zip | 97303-1695
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH-0017737
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License Number State | OR
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