Provider Demographics
NPI:1114379393
Name:AMELING, KAYLIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KAYLIN
Middle Name:
Last Name:AMELING
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 SW HIGHWAY 101
Mailing Address - Street 2:
Mailing Address - City:WALDPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97394-3035
Mailing Address - Country:US
Mailing Address - Phone:541-563-4848
Mailing Address - Fax:541-563-4747
Practice Address - Street 1:110 SW HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:WALDPORT
Practice Address - State:OR
Practice Address - Zip Code:97394-3035
Practice Address - Country:US
Practice Address - Phone:541-563-4848
Practice Address - Fax:541-563-4747
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6436205-1701183500000X
ORRPH-0019304183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist