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General NPI Number Information
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NPI Number | 1992960132
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Entity Type | Individual
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Provider Name | STEVEN KIRK NELSON RPH
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Gender | Male
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Dates
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Enumeration Date | 07/28/2008
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Last Update Date | 07/28/2008
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Provider Practice Location Address
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Address Line | 2283 SW 4TH AVE
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City | ONTARIO
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State | OR
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Zip | 97914-1849
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Country | US
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Telephone | 541-889-2188
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Fax |
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Provider Business Mailing Address
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Address Line | 1813 GRAHAM BLVD
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City | VALE
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State | OR
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Zip | 97918-5351
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Country | US
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Telephone | 541-473-2930
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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-0008452-P
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License Number State | OR
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