Provider Demographics
NPI:1487816831
Name:WHIPPLE, SUSAN ANNE (PHARM D)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ANNE
Last Name:WHIPPLE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2341 ASHLAND ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1407
Mailing Address - Country:US
Mailing Address - Phone:541-482-7409
Mailing Address - Fax:541-482-3812
Practice Address - Street 1:15166 HWY 62
Practice Address - Street 2:
Practice Address - City:EAGLE POINT
Practice Address - State:OR
Practice Address - Zip Code:97524-9784
Practice Address - Country:US
Practice Address - Phone:425-239-1010
Practice Address - Fax:425-239-1010
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60010898183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist