Provider Demographics
NPI:1063266609
Name:KUECHLER, KATHLEEN MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MARIE
Last Name:KUECHLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:KUECHLER-MACIAG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2424 CRATER LAKE HWY
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-4181
Mailing Address - Country:US
Mailing Address - Phone:541-734-2133
Mailing Address - Fax:
Practice Address - Street 1:2424 CRATER LAKE HWY
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-4181
Practice Address - Country:US
Practice Address - Phone:541-734-2133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH0014973183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist