Individual
DR. TREVOR JENNEWINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1990 14TH AVE SE, ALBANY, OR 97322-8504
(541) 812-2386
Mailing address
2665 NW GARRYANNA DR, 2, CORVALLIS, OR 97330-3686
(937) 654-5025
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RPH-0014533
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
0014533
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH-0014533
OREGON BOARD OF PHARMACY
OR
Enumeration date
01/31/2015
Last updated
12/17/2015
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