Provider Demographics
NPI:1730853375
Name:REESE, LORIANN NOELLE (RPH)
Entity type:Individual
Prefix:
First Name:LORIANN
Middle Name:NOELLE
Last Name:REESE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25699 SE STARK ST
Mailing Address - Street 2:
Mailing Address - City:TROUTDALE
Mailing Address - State:OR
Mailing Address - Zip Code:97060-3305
Mailing Address - Country:US
Mailing Address - Phone:503-665-9766
Mailing Address - Fax:
Practice Address - Street 1:25699 SE STARK ST
Practice Address - Street 2:
Practice Address - City:TROUTDALE
Practice Address - State:OR
Practice Address - Zip Code:97060-3305
Practice Address - Country:US
Practice Address - Phone:503-665-9766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-06
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0018214183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist