Provider Demographics
NPI:1457031064
Name:CHAN, STEPHANIE KUAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:KUAN
Last Name:CHAN
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 1:171 LOWRY LN APT 13
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-7962
Mailing Address - Country:US
Mailing Address - Phone:503-860-2148
Mailing Address - Fax:
Practice Address - Street 1:870 S FRONT ST STE 200
Practice Address - Street 2:
Practice Address - City:CENTRAL POINT
Practice Address - State:OR
Practice Address - Zip Code:97502-2779
Practice Address - Country:US
Practice Address - Phone:503-893-6900
Practice Address - Fax:503-487-3595
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-00191951835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care