Provider Demographics
NPI:1730489642
Name:WHITE, TJ (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TJ
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1101 GRANTS PASS PKWY
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-2333
Mailing Address - Country:US
Mailing Address - Phone:541-474-7234
Mailing Address - Fax:541-474-7240
Practice Address - Street 1:1101 GRANTS PASS PKWY
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-2333
Practice Address - Country:US
Practice Address - Phone:541-474-7234
Practice Address - Fax:541-474-7240
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2019-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0011845183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist