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General NPI Number Information
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NPI Number | 1225450117
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Entity Type | Individual
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Provider Name | LAURIE PATTY RPH
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Gender | Female
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Dates
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Enumeration Date | 01/10/2014
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Last Update Date | 01/10/2014
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Provider Practice Location Address
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Address Line | 47809 HIGHWAY 58 POB 697
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City | OAKRIDGE
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State | OR
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Zip | 97463-9572
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Country | US
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Telephone | 541-782-2617
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Fax | 541-782-3413
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Provider Business Mailing Address
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Address Line | 48339 7TH ST POB 697
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City | OAKRIDGE
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State | OR
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Zip | 97463-9641
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Country | US
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Telephone |
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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 | RPH-0007132
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License Number State | OR
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