Provider Demographics
NPI:1235399007
Name:LESSARD, MICHAEL NOEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:NOEL
Last Name:LESSARD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4359 BROTHERS AVE
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-9122
Mailing Address - Country:US
Mailing Address - Phone:907-209-1048
Mailing Address - Fax:907-789-6527
Practice Address - Street 1:4359 BROTHERS AVE
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-9122
Practice Address - Country:US
Practice Address - Phone:907-209-1048
Practice Address - Fax:907-789-6527
Is Sole Proprietor?:No
Enumeration Date:2008-06-14
Last Update Date:2008-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1551183500000X
OR8489183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1551OtherAK PHARMACY LICENSE
AK8489OtherOR PHARMACY LICENSE