Provider Demographics
NPI:1972803799
Name:ROBBINS, KENNETH NEAL (BS,RPH)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:NEAL
Last Name:ROBBINS
Suffix:
Gender:M
Credentials:BS,RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SW 20TH ST
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-1864
Mailing Address - Country:US
Mailing Address - Phone:541-278-4285
Mailing Address - Fax:541-278-4288
Practice Address - Street 1:201 SW 20TH ST
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-1864
Practice Address - Country:US
Practice Address - Phone:541-278-4285
Practice Address - Fax:541-278-4288
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7076183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist