Individual
KATHY DAWN PHELPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1101 GRANTS PASS PKWY, GRANTS PASS, OR 97526-2333
(541) 474-7234
Mailing address
1101 GRANTS PASS PKWY, GRANTS PASS, OR 97526-2333
(541) 474-7234
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0011052
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
11052
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0011052
PHARMACY LICENSE
OR
Enumeration date
03/08/2012
Last updated
04/27/2017
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