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General NPI Number Information
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NPI Number | 1962918110
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Entity Type | Individual
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Provider Name | BRIAN WELCH PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/26/2017
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Last Update Date | 12/16/2021
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Provider Practice Location Address
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Address Line | 4849 NE 138TH AVE
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City | PORTLAND
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State | OR
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Zip | 97230-3401
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Country | US
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Telephone | 503-257-3935
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Fax |
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Provider Business Mailing Address
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Address Line | 1642 WILLIAMS HWY
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City | GRANTS PASS
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State | OR
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Zip | 97527-5660
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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 | 0016438
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License Number State | OR
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