Provider Demographics
NPI:1154690642
Name:STANFIELD, MARK A (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:STANFIELD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 12TH ST
Mailing Address - Street 2:P.O. BOX 149
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1587
Mailing Address - Country:US
Mailing Address - Phone:541-387-6335
Mailing Address - Fax:
Practice Address - Street 1:810 12TH ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1587
Practice Address - Country:US
Practice Address - Phone:541-387-6335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-29
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0012815183500000X
OR00128121835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology
Yes183500000XPharmacy Service ProvidersPharmacist