Individual
MRS. LAURIE GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1727 SW ODEM MEDO RD, REDMOND, OR 97756-9573
(541) 923-7223
Mailing address
1727 SW ODEM MEDO RD, REDMOND, OR 97756-9573
(541) 923-7223
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8325
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8325
STATE PHARMACIST LICENSE
OR
Enumeration date
02/11/2012
Last updated
02/15/2012
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