Provider Demographics
NPI:1639443476
Name:MCGINLEY, ANGELA LYNN (CPHT)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:LYNN
Last Name:MCGINLEY
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20000 SE HIGHWAY 212
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:OR
Mailing Address - Zip Code:97089-8717
Mailing Address - Country:US
Mailing Address - Phone:503-558-8606
Mailing Address - Fax:503-558-9326
Practice Address - Street 1:20000 SE HIGHWAY 212
Practice Address - Street 2:
Practice Address - City:DAMASCUS
Practice Address - State:OR
Practice Address - Zip Code:97089-8717
Practice Address - Country:US
Practice Address - Phone:503-558-8606
Practice Address - Fax:503-558-9326
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-24
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORCPT-0001959183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORCPT-0001959Other'STATE PHARMACY TECH LICENSE'