Provider Demographics
NPI:1871371708
Name:THOMPSON, CASSIDY (PHARM D)
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 S HIGHWAY 97
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-9647
Mailing Address - Country:US
Mailing Address - Phone:541-504-4166
Mailing Address - Fax:541-504-4168
Practice Address - Street 1:1705 S HIGHWAY 97
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-9647
Practice Address - Country:US
Practice Address - Phone:541-504-4166
Practice Address - Fax:541-504-4168
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0019710183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist