Provider Demographics
NPI:1336397801
Name:DUNN, CONNIE CECILE (RPH)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:CECILE
Last Name:DUNN
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 1:1360 PLAZA BLVD
Mailing Address - Street 2:
Mailing Address - City:CENTRAL POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97502-2669
Mailing Address - Country:US
Mailing Address - Phone:541-665-3766
Mailing Address - Fax:541-665-3770
Practice Address - Street 1:1360 PLAZA BLVD
Practice Address - Street 2:
Practice Address - City:CENTRAL POINT
Practice Address - State:OR
Practice Address - Zip Code:97502-2669
Practice Address - Country:US
Practice Address - Phone:541-665-3766
Practice Address - Fax:541-665-3770
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-000096921835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORRPH-0009692OtherOREGON BOARD OF PHARMACY