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General NPI Number Information
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NPI Number | 1184997801
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Entity Type | Individual
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Provider Name | JANEEN VI FLAKE RPH
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Gender | Female
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Dates
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Enumeration Date | 02/10/2012
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Last Update Date | 02/10/2012
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Provider Practice Location Address
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Address Line | 3225 PACIFIC AVE
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City | FOREST GROVE
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State | OR
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Zip | 97116-1912
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Country | US
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Telephone | 503-357-2034
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Fax |
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Provider Business Mailing Address
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Address Line | 13256 SW HILLSHIRE DR
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City | TIGARD
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State | OR
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Zip | 97223-5600
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Country | US
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Telephone | 503-502-4649
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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 | 0007788
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License Number State | OR
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