Provider Demographics
NPI:1235430372
Name:NORMAN, DORA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DORA
Middle Name:
Last Name:NORMAN
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 1:19436 NEAL RD SE
Mailing Address - Street 2:
Mailing Address - City:SUBLIMITY
Mailing Address - State:OR
Mailing Address - Zip Code:97385-9757
Mailing Address - Country:US
Mailing Address - Phone:503-769-9679
Mailing Address - Fax:
Practice Address - Street 1:1535 N 1ST ST
Practice Address - Street 2:
Practice Address - City:STAYTON
Practice Address - State:OR
Practice Address - Zip Code:97383-1213
Practice Address - Country:US
Practice Address - Phone:503-769-5345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0012073183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist