Provider Demographics
NPI:1235361700
Name:AEBI, CYDREESE (PHD, RPH)
Entity Type:Individual
Prefix:DR
First Name:CYDREESE
Middle Name:
Last Name:AEBI
Suffix:
Gender:F
Credentials:PHD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 CENTER ST. NE
Mailing Address - Street 2:BLDG 35 RM 288 MAILBOX #11
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301
Mailing Address - Country:US
Mailing Address - Phone:503-945-9068
Mailing Address - Fax:503-945-0985
Practice Address - Street 1:2600 CENTER ST NE
Practice Address - Street 2:BLDG 35 RM 288 MAILBOX #11
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-2669
Practice Address - Country:US
Practice Address - Phone:503-945-9068
Practice Address - Fax:503-945-0985
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0006913183500000X
WA00011917183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist