Provider Demographics
NPI:1851540629
Name:TOLMAN, JENNIFER LOUISE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LOUISE
Last Name:TOLMAN
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 1:198 A ST W
Mailing Address - Street 2:
Mailing Address - City:VALE
Mailing Address - State:OR
Mailing Address - Zip Code:97918-1302
Mailing Address - Country:US
Mailing Address - Phone:541-473-3333
Mailing Address - Fax:547-473-9689
Practice Address - Street 1:198 A ST W
Practice Address - Street 2:
Practice Address - City:VALE
Practice Address - State:OR
Practice Address - Zip Code:97918-1302
Practice Address - Country:US
Practice Address - Phone:541-473-3333
Practice Address - Fax:547-473-9689
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0011321183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist