Provider Demographics
NPI:1134344054
Name:STRANDBERG, LEE R (RPH, PHD)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:R
Last Name:STRANDBERG
Suffix:
Gender:M
Credentials:RPH, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 GEARY ST SE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97322-6842
Mailing Address - Country:US
Mailing Address - Phone:541-812-5544
Mailing Address - Fax:
Practice Address - Street 1:815 NW 9TH ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-6173
Practice Address - Country:US
Practice Address - Phone:541-812-5544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6217183500000X
OR00062171835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist