Basic Information
| Provider Information | |||||||||
| NPI: | 1629471792 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SOH | ||||||||
| FirstName: | PAMELA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3007 GEHLAR RD NW APT 2009 | ||||||||
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| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973044274 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7752233669 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1992 LANCASTER DR NE | ||||||||
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| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973051021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5034285004 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2014 | ||||||||
| LastUpdateDate: | 10/03/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P0018X | RPH-0014399 | OR | Y | Pharmacy Service Providers | Pharmacist | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
No ID Information.