Provider Demographics
NPI:1518231950
Name:GREER, KYLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:
Last Name:GREER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 SE FIRST
Mailing Address - Street 2:
Mailing Address - City:CANBY
Mailing Address - State:OR
Mailing Address - Zip Code:97013
Mailing Address - Country:US
Mailing Address - Phone:503-263-4128
Mailing Address - Fax:503-263-4123
Practice Address - Street 1:1401 SE FIRST
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:OR
Practice Address - Zip Code:97013
Practice Address - Country:US
Practice Address - Phone:503-263-4128
Practice Address - Fax:503-263-4123
Is Sole Proprietor?:No
Enumeration Date:2012-03-02
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0012230183500000X
OR122301835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist