Healthcare Provider Details

I. General information

NPI: 1295650505
Provider Name (Legal Business Name): TESHA OHLHAUSER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 GAME FARM RD
SPRINGFIELD OR
97477
US

IV. Provider business mailing address

3555 GAME FARM RD
SPRINGFIELD OR
97477
US

V. Phone/Fax

Practice location:
  • Phone: 541-578-4280
  • Fax: 541-578-4287
Mailing address:
  • Phone: 541-578-4280
  • Fax: 541-578-4287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH-0016083
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: