Provider Demographics
NPI:1144313644
Name:DOOLEY, NANCY JANE (CPCHT)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:JANE
Last Name:DOOLEY
Suffix:
Gender:F
Credentials:CPCHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 CONNECTICUT
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97459
Mailing Address - Country:US
Mailing Address - Phone:541-756-4812
Mailing Address - Fax:
Practice Address - Street 1:2310 CONNECTICUT
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:OR
Practice Address - Zip Code:97459
Practice Address - Country:US
Practice Address - Phone:541-756-4812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORCPT0000073183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician