Provider Demographics
NPI:1326705567
Name:PINON, BLANCA J (RPH)
Entity Type:Individual
Prefix:
First Name:BLANCA
Middle Name:J
Last Name:PINON
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 1:3705 AIRPORT DR
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-9302
Mailing Address - Country:US
Mailing Address - Phone:509-853-6442
Mailing Address - Fax:
Practice Address - Street 1:1216 W 6TH ST
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-3516
Practice Address - Country:US
Practice Address - Phone:541-296-1748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH0018654183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist