Individual
MISS CHANELLE AJIMURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2919 KIPLING WAY, EUGENE, OR 97408-7458
(808) 639-0824
Mailing address
2919 KIPLING WAY, EUGENE, OR 97408-7458
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0016369
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
11/15/2017
Last updated
06/16/2018
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