Provider Demographics
NPI:1851790091
Name:GISSEL, ASHLEY (RPH)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:
Last Name:GISSEL
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 1:1775 E IDAHO AVE
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-3009
Mailing Address - Country:US
Mailing Address - Phone:541-889-6040
Mailing Address - Fax:541-889-9423
Practice Address - Street 1:1775 E IDAHO AVE
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-3009
Practice Address - Country:US
Practice Address - Phone:541-889-6040
Practice Address - Fax:541-889-9423
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR8841183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist