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General NPI Number Information
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NPI Number | 1245358720
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Entity Type | Individual
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Provider Name | ROBIN Z. BOLTON RPH
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Gender | Male
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1900 SE MCLAUGHIN OREGON CITY SHOPPING CENTER #22- RITE AID PHARMACY
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City | OREGON CITY
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State | OR
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Zip | 97045
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Country | US
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Telephone | 503-656-1020
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Fax | 503-655-6690
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Provider Business Mailing Address
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Address Line | 17020 CHAPIN WAY
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City | LAKE OSWEGO
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State | OR
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Zip | 97034-6306
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Country | US
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Telephone | 503-636-9576
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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 | 5273
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License Number State | OR
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