Provider Demographics
NPI:1508119355
Name:KRAUSE, LAURI A (PHARMD)
Entity Type:Individual
Prefix:
First Name:LAURI
Middle Name:A
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31751 LYNX HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:CRESWELL
Mailing Address - State:OR
Mailing Address - Zip Code:97426-9383
Mailing Address - Country:US
Mailing Address - Phone:208-680-0922
Mailing Address - Fax:
Practice Address - Street 1:1891 PIONEER PKWY E
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-3935
Practice Address - Country:US
Practice Address - Phone:541-747-6627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-17
Last Update Date:2019-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPRH-00103551835P0018X
IDP59461835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist