Provider Demographics
NPI:1497110605
Name:DAHLENBURG, JOSHUA L (PHARM D)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:L
Last Name:DAHLENBURG
Suffix:
Gender:M
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 1:250 NW MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WINSTON
Mailing Address - State:OR
Mailing Address - Zip Code:97496-6574
Mailing Address - Country:US
Mailing Address - Phone:541-236-7060
Mailing Address - Fax:541-236-7061
Practice Address - Street 1:250 NW MAIN ST
Practice Address - Street 2:
Practice Address - City:WINSTON
Practice Address - State:OR
Practice Address - Zip Code:97496-6574
Practice Address - Country:US
Practice Address - Phone:541-236-7060
Practice Address - Fax:541-236-7061
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-15
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-00100440183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist