Individual
KELLIE TIPPETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
211 E CASCADE AVE, SISTERS, OR 97759-1140
(541) 549-6221
(541) 549-1110
Mailing address
PO BOX 580, SISTERS, OR 97759-0580
(541) 549-6221
(541) 549-1110
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0014110
OR
Other
Enumeration date
09/16/2014
Last updated
09/16/2014
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