Provider Demographics
NPI:1285804930
Name:COHN, DANIEL B (RPH)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:B
Last Name:COHN
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 1:975 WINDGATE ST S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-5638
Mailing Address - Country:US
Mailing Address - Phone:209-915-2026
Mailing Address - Fax:
Practice Address - Street 1:4070 27TH CT SE
Practice Address - Street 2:SUITE 100
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-1359
Practice Address - Country:US
Practice Address - Phone:503-383-3315
Practice Address - Fax:503-383-3412
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53-02-022100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist