Individual
TINA ANN PAVELIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
635 N ARROWLEAF TRAIL, SISTERS, OR 97759
(541) 549-6221
Mailing address
1575 NW WILD RYE CIR, BEND, OR 97703-5362
(541) 848-7371
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
007112
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
7112
OR
Other
Enumeration date
11/02/2011
Last updated
02/23/2021
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