Provider Demographics
NPI:1700038437
Name:BELKNAP, JANICE LYNN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:LYNN
Last Name:BELKNAP
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 SE DWYER DR
Mailing Address - Street 2:ANNEX BLDG SUITE #304
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-6548
Mailing Address - Country:US
Mailing Address - Phone:503-513-8343
Mailing Address - Fax:503-513-8069
Practice Address - Street 1:3300 SE DWYER DR
Practice Address - Street 2:ANNEX BLDG SUITE #304
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-6548
Practice Address - Country:US
Practice Address - Phone:503-513-8343
Practice Address - Fax:503-513-8069
Is Sole Proprietor?:No
Enumeration Date:2008-10-13
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11330183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist