Provider Demographics
NPI:1376816934
Name:NETLAND, JAMES REED (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:REED
Last Name:NETLAND
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 1:102 MARTIN DR
Mailing Address - Street 2:
Mailing Address - City:STAYTON
Mailing Address - State:OR
Mailing Address - Zip Code:97383-1296
Mailing Address - Country:US
Mailing Address - Phone:503-769-2616
Mailing Address - Fax:503-769-2616
Practice Address - Street 1:102 MARTIN DR
Practice Address - Street 2:
Practice Address - City:STAYTON
Practice Address - State:OR
Practice Address - Zip Code:97383-1296
Practice Address - Country:US
Practice Address - Phone:503-769-2616
Practice Address - Fax:503-769-2616
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7539183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist