Provider Demographics
NPI:1427509355
Name:DULWICK, ALLAN (RPH)
Entity type:Individual
Prefix:
First Name:ALLAN
Middle Name:
Last Name:DULWICK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70686 WOODLANDSTAR
Mailing Address - Street 2:PO BOX 8000, PMB 8069
Mailing Address - City:SISTERS
Mailing Address - State:OR
Mailing Address - Zip Code:97759-2706
Mailing Address - Country:US
Mailing Address - Phone:503-260-8768
Mailing Address - Fax:
Practice Address - Street 1:2525 SE TUALATIN VALLEY HWY
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-7935
Practice Address - Country:US
Practice Address - Phone:503-681-0262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-15
Last Update Date:2016-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6428183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist