Provider Demographics
NPI:1720324361
Name:DYE, LYN E (PHARMD)
Entity Type:Individual
Prefix:
First Name:LYN
Middle Name:E
Last Name:DYE
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 1:22855 NE PARK LN
Mailing Address - Street 2:
Mailing Address - City:WOOD VILLAGE
Mailing Address - State:OR
Mailing Address - Zip Code:97060-2606
Mailing Address - Country:US
Mailing Address - Phone:503-492-5033
Mailing Address - Fax:
Practice Address - Street 1:22855 NE PARK LN
Practice Address - Street 2:
Practice Address - City:WOOD VILLAGE
Practice Address - State:OR
Practice Address - Zip Code:97060-2606
Practice Address - Country:US
Practice Address - Phone:503-492-5033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-01
Last Update Date:2013-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR9366183500000X
IDP5251183500000X
WAPH00040256183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist