Individual
LEAH A STASKIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 W 6TH ST, THE DALLES, OR 97058-3520
(541) 298-5680
Mailing address
1018 W 8TH PL APT 7, THE DALLES, OR 97058-1028
(720) 933-2187
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH.0016376
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHA.0021918
COLORADO PHARMACIST LICENSE
CO
01
—
RPH.0016376
OREGON PHARMACIST LICENSE
OR
Enumeration date
12/02/2017
Last updated
12/02/2017
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