Phillip Corra
Pharmacist in Portland, OR. Individual provider (NPI-1).
NPI number1447925136
StatusActive
Last updated in NPPESAug 13, 2021
Details
- NPI
- 1447925136
- Entity type
- Individual (NPI-1)
- Name
- Phillip Corra
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 13, 2021
- Certification date
- Jul 20, 2021
- Last updated
- Aug 13, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 0007140 | OR | Yes |
Practice location
916 East Evergreen BlvdPortland, OR 97231
Phone 503-647-8106
Mailing address
916 East Evergreen BlvdPortland, OR 97231
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