Provider Demographics
NPI:1710137021
Name:HAYNES, LORINDA KAY (RPH)
Entity Type:Individual
Prefix:
First Name:LORINDA
Middle Name:KAY
Last Name:HAYNES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7655 SW NYBERG ST
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-8611
Mailing Address - Country:US
Mailing Address - Phone:503-885-1072
Mailing Address - Fax:503-691-0838
Practice Address - Street 1:7655 SW NYBERG ST
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-8611
Practice Address - Country:US
Practice Address - Phone:503-885-1072
Practice Address - Fax:503-691-0838
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR8767183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist