Individual
JONI CLANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 N 10TH AVE, STAYTON, OR 97383-1311
(503) 769-9223
Mailing address
PO BOX 619, SUBLIMITY, OR 97385-0619
(508) 243-2909
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11088
OR
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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