Provider Demographics
NPI:1962741652
Name:LEGER-JEFFREY, DAVID (RPH BS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:LEGER-JEFFREY
Suffix:
Gender:M
Credentials:RPH BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 W 12TH AVE APT 207
Mailing Address - Street 2:THE LINCOLN SCHOOL
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-4086
Mailing Address - Country:US
Mailing Address - Phone:541-999-5175
Mailing Address - Fax:
Practice Address - Street 1:3333 W 11TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-3053
Practice Address - Country:US
Practice Address - Phone:541-484-3013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH0008379183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist