Provider Demographics
NPI:1124426440
Name:LINARES, ROBERTO WILLIAM (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBERTO
Middle Name:WILLIAM
Last Name:LINARES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 SW 53RD ST
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-2630
Mailing Address - Country:US
Mailing Address - Phone:541-758-3392
Mailing Address - Fax:866-260-2487
Practice Address - Street 1:1555 SW 53RD ST
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-2630
Practice Address - Country:US
Practice Address - Phone:541-758-3392
Practice Address - Fax:866-260-2487
Is Sole Proprietor?:No
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR8221183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist