Provider Demographics
NPI:1679848527
Name:HALL, RALPH GEORGE (RPH)
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:GEORGE
Last Name:HALL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 COMMERCIAL ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-4635
Mailing Address - Country:US
Mailing Address - Phone:503-585-3533
Mailing Address - Fax:
Practice Address - Street 1:3450 COMMERCIAL ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4635
Practice Address - Country:US
Practice Address - Phone:503-585-3533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-11
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7198183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist