Provider Demographics
NPI:1992525877
Name:GUEVARRA, CAITHLYNE MARIE
Entity type:Individual
Prefix:
First Name:CAITHLYNE MARIE
Middle Name:
Last Name:GUEVARRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94996 STOCK SLOUGH LN
Mailing Address - Street 2:
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-6347
Mailing Address - Country:US
Mailing Address - Phone:951-214-1340
Mailing Address - Fax:
Practice Address - Street 1:1020 1ST ST
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-3806
Practice Address - Country:US
Practice Address - Phone:541-269-4033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR00202681835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist