Provider Demographics
NPI:1982977419
Name:YANCEY, NANCY LUANN (RPH)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:LUANN
Last Name:YANCEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:LUANN
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:625 SE MILLER AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:OR
Mailing Address - Zip Code:97338-2634
Mailing Address - Country:US
Mailing Address - Phone:503-623-2400
Mailing Address - Fax:503-623-5799
Practice Address - Street 1:625 SE MILLER AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338-2634
Practice Address - Country:US
Practice Address - Phone:503-623-2400
Practice Address - Fax:503-623-5799
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-00007652183500000X
ORRPH-00076521835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist