Provider Demographics
NPI:1801946553
Name:KOEHN, LINDA KAY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:KAY
Last Name:KOEHN
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 1:665 WINTER ST.
Mailing Address - Street 2:SALEM HOSPITAL
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97309
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:665 WINTER ST.
Practice Address - Street 2:SALEM HOSPITAL
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97309
Practice Address - Country:US
Practice Address - Phone:503-561-5295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-139171835G0303X
OR0011712183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric