Provider Demographics
NPI:1548746597
Name:HENCLEY, CASSIDY ELGAN (PHARMD)
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:ELGAN
Last Name:HENCLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1826 TANEY ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-1547
Mailing Address - Country:US
Mailing Address - Phone:208-244-1693
Mailing Address - Fax:541-747-0655
Practice Address - Street 1:2644 SUZANNE WAY
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97408-7418
Practice Address - Country:US
Practice Address - Phone:417-474-3005
Practice Address - Fax:541-747-0655
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-12
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP8061183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist