Provider Demographics
NPI:1447916051
Name:COONS, LAUREN ANN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ANN
Last Name:COONS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ANN
Other - Last Name:PULS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1911 NE 60TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-4129
Mailing Address - Country:US
Mailing Address - Phone:503-679-9081
Mailing Address - Fax:
Practice Address - Street 1:100 SW MARKET ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201-5723
Practice Address - Country:US
Practice Address - Phone:503-225-4908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH0014330183500000X, 1835P0018X
IDP98211835P0018X
GARPH027229183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist