Individual
PATRICIA KAY JOLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
700 CAMPBELL ST, BAKER CITY, OR 97814-2212
(541) 523-0607
(541) 523-0589
Mailing address
700 CAMPBELL ST, BAKER CITY, OR 97814-2212
(541) 523-0607
(541) 523-0589
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PH 00019693
WA
183500000X
Pharmacist
Primary
RPH-0006801
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH 00019693
STATE PHARMACIST LICENSE
WA
01
—
RPH-0006801
STATE PHARMACIST LICENSE
OR
Enumeration date
02/10/2012
Last updated
02/10/2012
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