Provider Demographics
NPI:1821499690
Name:SMITH, ASHLYN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ASHLYN
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ASHLYN
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1330 GOLDFISH FARM RD SE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-5154
Mailing Address - Country:US
Mailing Address - Phone:541-971-4062
Mailing Address - Fax:
Practice Address - Street 1:1330 GOLDFISH FARM RD SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-5154
Practice Address - Country:US
Practice Address - Phone:541-971-4062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0012935183500000X
WAPH0056073183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORRPH-0012935OtherPHARMACIST LICENSE
WAPH00056073OtherPHARMACIST LICENSE