Provider Demographics
NPI:1467551853
Name:LIEBENAU, LONA E (RPH)
Entity Type:Individual
Prefix:MS
First Name:LONA
Middle Name:E
Last Name:LIEBENAU
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 1:1675 COBURG RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4854
Mailing Address - Country:US
Mailing Address - Phone:541-344-0015
Mailing Address - Fax:541-344-4946
Practice Address - Street 1:1675 COBURG RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4854
Practice Address - Country:US
Practice Address - Phone:541-344-0015
Practice Address - Fax:541-344-4946
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2010-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV08208183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist