Provider Demographics
NPI:1447260922
Name:MEYERSICK, JOYCE MARIE (RPH)
Entity type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:MARIE
Last Name:MEYERSICK
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 1:225 NE 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-4818
Mailing Address - Country:US
Mailing Address - Phone:503-835-6013
Mailing Address - Fax:
Practice Address - Street 1:225 NE 3RD ST
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-4818
Practice Address - Country:US
Practice Address - Phone:503-472-2146
Practice Address - Fax:503-435-1493
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7666183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR7666OtherRPH