Provider Demographics
NPI:1851777205
Name:CUILLIER, AMANDA (RPH)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:CUILLIER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:HARMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:1755 IVY ST
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97448-2017
Mailing Address - Country:US
Mailing Address - Phone:541-998-4526
Mailing Address - Fax:541-998-4528
Practice Address - Street 1:1755 IVY ST
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:OR
Practice Address - Zip Code:97448-2017
Practice Address - Country:US
Practice Address - Phone:541-998-4526
Practice Address - Fax:541-998-4528
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-08
Last Update Date:2015-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0014819183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist