Individual
MR. TIMOTHY WARREN EVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH., M.S.
Contact information
Practice address
2714 HARBECK RD, GRANTS PASS, OR 97527-5630
(541) 476-0361
Mailing address
2714 HARBECK RD, GRANTS PASS, OR 97527-5630
(541) 476-0361
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
6119
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6119
STATE BOARD OF PHARMACY
OR
Enumeration date
03/24/2018
Last updated
06/16/2018
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