Provider Demographics
NPI:1770888083
Name:CLUNY, HANNI (PHARMD)
Entity type:Individual
Prefix:
First Name:HANNI
Middle Name:
Last Name:CLUNY
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 1:2836 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97116-1896
Mailing Address - Country:US
Mailing Address - Phone:503-359-8706
Mailing Address - Fax:503-359-9754
Practice Address - Street 1:2836 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:FOREST GROVE
Practice Address - State:OR
Practice Address - Zip Code:97116-1896
Practice Address - Country:US
Practice Address - Phone:503-359-8706
Practice Address - Fax:503-359-9754
Is Sole Proprietor?:No
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10592183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist