Healthcare Provider Details

I. General information

NPI: 1194753970
Provider Name (Legal Business Name): JACQUELYN STEELE PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 12/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 PROVIDENCE DR
NEWBERG OR
97132-7485
US

IV. Provider business mailing address

1001 PROVIDENCE DR
NEWBERG OR
97132-7485
US

V. Phone/Fax

Practice location:
  • Phone: 503-537-5872
  • Fax: 503-537-5890
Mailing address:
  • Phone: 503-537-5872
  • Fax: 503-537-5890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH-0010325
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: