Provider Demographics
NPI:1396013082
Name:GONZALES, JOSEPH ROCKWELL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ROCKWELL
Last Name:GONZALES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 SE ROUNDELAY ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4791
Mailing Address - Country:US
Mailing Address - Phone:503-530-1447
Mailing Address - Fax:
Practice Address - Street 1:17495 SW FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:ALOHA
Practice Address - State:OR
Practice Address - Zip Code:97007-3212
Practice Address - Country:US
Practice Address - Phone:503-848-7700
Practice Address - Fax:503-848-7710
Is Sole Proprietor?:No
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0012937183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist