Provider Demographics
NPI:1689101958
Name:FITZPATRICK, ARIANA NOELLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ARIANA
Middle Name:NOELLE
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ARIANA
Other - Middle Name:NOELLE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:102 PAHATU ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BONNEVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98639-4635
Mailing Address - Country:US
Mailing Address - Phone:971-227-0956
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
Practice Address - Country:US
Practice Address - Phone:541-296-3190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0015065183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist