Provider Demographics
NPI:1346429172
Name:WARD, PATRICIA DAWN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:DAWN
Last Name:WARD
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 1:615 SW KECK DR
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-6691
Mailing Address - Country:US
Mailing Address - Phone:503-474-0894
Mailing Address - Fax:503-434-6296
Practice Address - Street 1:615 SW KECK DR
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-6691
Practice Address - Country:US
Practice Address - Phone:503-474-0894
Practice Address - Fax:503-434-6296
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0008461183500000X
OR84611835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist