Provider Demographics
NPI:1225394166
Name:BOWEN, TERESA ANNE (RPH)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:ANNE
Last Name:BOWEN
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 1:311 COBURG RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6109
Mailing Address - Country:US
Mailing Address - Phone:541-342-7893
Mailing Address - Fax:541-334-0253
Practice Address - Street 1:311 COBURG RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6109
Practice Address - Country:US
Practice Address - Phone:541-342-7893
Practice Address - Fax:541-334-0253
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-04
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0008635183500000X
OR0086351835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist