Provider Demographics
NPI:1205069523
Name:FLEISSNER, GINNY LYN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GINNY
Middle Name:LYN
Last Name:FLEISSNER
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 1:3355 N DELTA HWY UNIT 156
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97408-5915
Mailing Address - Country:US
Mailing Address - Phone:541-514-5686
Mailing Address - Fax:
Practice Address - Street 1:1210 MOHAWK BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-3349
Practice Address - Country:US
Practice Address - Phone:541-747-3841
Practice Address - Fax:541-747-3846
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0011002183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist