Provider Demographics
NPI:1245840917
Name:YANEZ, ERIC (PHARMD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:YANEZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 NW 9TH ST STE 123
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-6164
Mailing Address - Country:US
Mailing Address - Phone:541-768-6108
Mailing Address - Fax:
Practice Address - Street 1:815 NW 9TH ST STE 123
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-6164
Practice Address - Country:US
Practice Address - Phone:541-768-6108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0011354183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist