Provider Demographics
NPI:1841643681
Name:PAHLMEYER, LAURA (PHARMD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:PAHLMEYER
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 1:24988 SE STARK ST
Mailing Address - Street 2:STE 220
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030
Mailing Address - Country:US
Mailing Address - Phone:503-674-1580
Mailing Address - Fax:
Practice Address - Street 1:24988 SE STARK ST STE 220
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-8324
Practice Address - Country:US
Practice Address - Phone:503-674-1580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-17
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60619577183500000X
ORRPH-0014792183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist