Provider Demographics
NPI:1871734202
Name:EMOTO, ANNA LEE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:LEE
Last Name:EMOTO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ANNA
Other - Middle Name:LEE
Other - Last Name:HORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1690 SW ALLEN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-5559
Mailing Address - Country:US
Mailing Address - Phone:541-471-9043
Mailing Address - Fax:541-471-9047
Practice Address - Street 1:1690 SW ALLEN CREEK RD
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-5559
Practice Address - Country:US
Practice Address - Phone:541-471-9043
Practice Address - Fax:541-471-9047
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-14
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-00109671835P0018X, 183500000X
TX40601183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist