Provider Demographics
NPI:1215237904
Name:CHESS, JOHN III (RPH)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:CHESS
Suffix:III
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 1:275 E ANCHOR AVE
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97404-1773
Mailing Address - Country:US
Mailing Address - Phone:541-285-1672
Mailing Address - Fax:
Practice Address - Street 1:275 E ANCHOR AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-1773
Practice Address - Country:US
Practice Address - Phone:541-285-1672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10669183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist