Individual
LORELEI DENURA VELASCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16261 HIGHWAY 101 S, HARBOR, OR 97415-9499
(541) 469-3121
Mailing address
994A PARKVIEW DR, BROOKINGS, OR 97415-8285
(530) 927-8183
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0012895
OR
Other
Enumeration date
11/19/2011
Last updated
11/19/2011
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