Provider Demographics
NPI:1801139027
Name:KAMPEN, CYNTHIA JANE (RPH)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:JANE
Last Name:KAMPEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:JANE
Other - Last Name:KAMPEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:150 NE 20TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97365-1851
Mailing Address - Country:US
Mailing Address - Phone:541-574-1733
Mailing Address - Fax:541-574-0195
Practice Address - Street 1:150 NE 20TH ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:OR
Practice Address - Zip Code:97365-1851
Practice Address - Country:US
Practice Address - Phone:541-574-1733
Practice Address - Fax:541-574-0195
Is Sole Proprietor?:No
Enumeration Date:2013-04-05
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC11523183500000X
OR00146051835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist