Provider Demographics
NPI:1073980405
Name:LECZEL, MARGARET (RPH)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:LECZEL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 N PACIFIC HWY STE 3
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97424-1117
Mailing Address - Country:US
Mailing Address - Phone:541-942-7799
Mailing Address - Fax:541-930-7069
Practice Address - Street 1:1205 N PACIFIC HWY STE 3
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:OR
Practice Address - Zip Code:97424-1117
Practice Address - Country:US
Practice Address - Phone:541-942-7799
Practice Address - Fax:541-930-7069
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-02
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR8683183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR8683OtherSTATE PHARMACIST LICENSE