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General NPI Number Information
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NPI Number | 1871927319
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Entity Type | Individual
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Provider Name | DANIEL HOLLAND LINDSTROM PHARM D.
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Gender | Male
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Dates
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Enumeration Date | 09/01/2013
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Last Update Date | 09/23/2015
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Provider Practice Location Address
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Address Line | 7591 CRATER LAKE HWY SUITE A
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City | WHITE CITY
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State | OR
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Zip | 97503-1663
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Country | US
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Telephone | 541-826-4414
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Fax | 541-416-8366
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Provider Business Mailing Address
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Address Line | 7591 CRATER LAKE HWY SUITE A
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City | WHITE CITY
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State | OR
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Zip | 97503-1663
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Country | US
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Telephone | 541-826-4414
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Fax | 541-416-8366
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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 | S019953
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0013792
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License Number State | OR
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