Prescriber Profile
NPI
4567890123
DEA
MP4567890
Specialty
Family Medicine
License State
OR
License #
D-456789
License Expiry
2027-09-30
lisa.park@parkwellness.com
Phone
(503) 555-0134
Clinic Address
Park Wellness Clinic
555 Wellness Ave
Portland, OR 97201
Actions
Stats
Total Orders1
Active Orders0
Prescription History
| ORDER | PATIENT | PRODUCTS | STATUS | PROTOCOL | DATE |
|---|---|---|---|---|---|
| ORD-2026-0180 | S.W. (45) | Selank, 10mg Nasal, Semax Nasal, 10mg | Delivered | Nootropic Peptide Protocol | Mar 21 |