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General NPI Number Information
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NPI Number | 1134412067
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Entity Type | Individual
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Provider Name | SU YAN HAR PHARM D
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Gender | Female
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Dates
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Enumeration Date | 05/25/2011
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Last Update Date | 05/25/2011
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Provider Practice Location Address
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Address Line | 1430 NW GARDEN VALLEY BLVD
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City | ROSEBURG
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State | OR
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Zip | 97471-1766
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Country | US
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Telephone | 541-673-1650
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Fax |
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Provider Business Mailing Address
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Address Line | 175 MOUNTAIN DR
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City | ROSEBURG
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State | OR
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Zip | 97471-9641
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Country | US
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Telephone | 541-817-4630
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 9020
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License Number State | OR
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