Provider Demographics
NPI:1336582451
Name:BROWN, HEATHER ERIN (RPH)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ERIN
Last Name:BROWN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 W EVERGREEN BLVD
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-3035
Mailing Address - Country:US
Mailing Address - Phone:360-213-2236
Mailing Address - Fax:360-213-2238
Practice Address - Street 1:406 MCCLAINE ST
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381-1921
Practice Address - Country:US
Practice Address - Phone:503-873-8391
Practice Address - Fax:360-213-2238
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0008078183500000X
ORPH00080781835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORRPH-0008078OtherPHARMACIST LICENSE NUMBER
ORRPH-0008078-POtherPHARMACIST PRECEPTOR NUMBER