Provider Demographics
NPI:1033714654
Name:PRIEST, ALISON JOY (CPHT)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:JOY
Last Name:PRIEST
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2061
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:OR
Mailing Address - Zip Code:97024-1813
Mailing Address - Country:US
Mailing Address - Phone:503-334-5139
Mailing Address - Fax:
Practice Address - Street 1:23500 NE SANDY BLVD
Practice Address - Street 2:
Practice Address - City:WOOD VILLAGE
Practice Address - State:OR
Practice Address - Zip Code:97060-9653
Practice Address - Country:US
Practice Address - Phone:503-334-5139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORCPT-0005490183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician