Provider Demographics
NPI:1578081220
Name:WASHINGTON, COURTNEY MARIE (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:MARIE
Last Name:WASHINGTON
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 1:124 LANCASTER DR SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97317-5331
Mailing Address - Country:US
Mailing Address - Phone:503-428-5004
Mailing Address - Fax:503-428-5007
Practice Address - Street 1:1701 SHAFF RD
Practice Address - Street 2:
Practice Address - City:STAYTON
Practice Address - State:OR
Practice Address - Zip Code:97383-1091
Practice Address - Country:US
Practice Address - Phone:503-769-6736
Practice Address - Fax:866-267-6598
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPI-0011726183500000X
ORRPH-0016200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist