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General NPI Number Information
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NPI Number | 1629170451
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Entity Type | Organization
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Legal Business Name | JB SOWLES
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 911 SW 4TH AVE
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City | CANBY
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State | OR
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Zip | 97013-3832
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Country | US
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Telephone | 503-266-2081
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Fax | 503-263-3255
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Provider Business Mailing Address
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Address Line | 911 SW 4TH AVE
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City | CANBY
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State | OR
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Zip | 97013-3832
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Country | US
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Telephone | 503-266-2081
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Fax | 503-263-3255
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | MR. JOHN BRADLEY SOWLES
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Credential | RPH
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Telephone | 503-266-2081
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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 | RP-0000597-CS
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License Number State | OR
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