Provider Demographics
NPI:1679889513
Name:REYNOLDS, FRANK ANDREW (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:ANDREW
Last Name:REYNOLDS
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 1:515 MOUNT HOOD ST
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-3589
Mailing Address - Country:US
Mailing Address - Phone:541-296-3190
Mailing Address - Fax:
Practice Address - Street 1:515 MOUNT HOOD ST
Practice Address - Street 2:
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-3589
Practice Address - Country:US
Practice Address - Phone:541-296-3190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0012003183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist