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General NPI Number Information
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NPI Number | 1639442395
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Entity Type | Individual
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Provider Name | LYNDSEY RENAE DUBISAR CPHT
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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 | 1727 SW ODEM MEDO RD
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City | REDMOND
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State | OR
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Zip | 97756-9573
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Country | US
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Telephone | 541-923-7223
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Fax | 541-923-7228
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Provider Business Mailing Address
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Address Line | 1727 SW ODEM MEDO RD
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City | REDMOND
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State | OR
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Zip | 97756-9573
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Country | US
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Telephone | 541-923-7223
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Fax | 541-923-7228
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | CPT-0006375
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License Number State | OR
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