MR. William Fred Broussard, RPH

NPI #1043217961 in Portland, Oregon

Provider Information

NPI Number: 1043217961
Entity Type: Individual
Name: MR. William Fred Broussard, RPH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: RPH
Enumeration Date: Jul 7, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 5415 SW BEAVERTON HILLSDALE HWY
City: Portland
State: Oregon
ZIP Code: 97221-1918
Phone: (503) 246-5077

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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