Provider Demographics
NPI:1780935767
Name:YANTIS, LEANNE ELIZABETH (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:LEANNE
Middle Name:ELIZABETH
Last Name:YANTIS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16261 HIGHWAY 101 S
Mailing Address - Street 2:
Mailing Address - City:HARBOR
Mailing Address - State:OR
Mailing Address - Zip Code:97415-9499
Mailing Address - Country:US
Mailing Address - Phone:541-469-3121
Mailing Address - Fax:541-469-1866
Practice Address - Street 1:16261 HIGHWAY 101 S
Practice Address - Street 2:
Practice Address - City:HARBOR
Practice Address - State:OR
Practice Address - Zip Code:97415-9499
Practice Address - Country:US
Practice Address - Phone:541-469-3121
Practice Address - Fax:541-469-1866
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0011104183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist