Provider Demographics
NPI:1598168411
Name:TALLMAN, KRISTIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:TALLMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:MORRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:725 S WAHANNA RD
Mailing Address - Street 2:
Mailing Address - City:SEASIDE
Mailing Address - State:OR
Mailing Address - Zip Code:97138-7735
Mailing Address - Country:US
Mailing Address - Phone:503-717-7045
Mailing Address - Fax:503-717-7629
Practice Address - Street 1:725 S WAHANNA RD
Practice Address - Street 2:
Practice Address - City:SEASIDE
Practice Address - State:OR
Practice Address - Zip Code:97138-7735
Practice Address - Country:US
Practice Address - Phone:503-717-7045
Practice Address - Fax:503-717-7629
Is Sole Proprietor?:No
Enumeration Date:2014-10-06
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA22313183500000X
ORRPH-00154411835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist