Provider Demographics
NPI:1578863064
Name:BOLLAND, BRIANNE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:BRIANNE
Middle Name:
Last Name:BOLLAND
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 1:2249 CASCADE AVE
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1001
Mailing Address - Country:US
Mailing Address - Phone:541-386-8374
Mailing Address - Fax:541-386-4636
Practice Address - Street 1:2249 CASCADE AVE
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1001
Practice Address - Country:US
Practice Address - Phone:541-386-8374
Practice Address - Fax:541-386-4636
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11073183500000X
ORRPH-00110731835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist