Individual
MRS. JOSIE RENEE VANDORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
73265 CONFEDERATED WAY, PENDLETON, OR 97801
(541) 966-9830
Mailing address
72278 NASH LN, PENDLETON, OR 97801-9078
(541) 278-1978
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9046
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165441
—
OR
Enumeration date
08/11/2006
Last updated
07/09/2007
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