Provider Demographics
NPI:1831817782
Name:DOANE, ALISON BLAIR (PHARMD)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:BLAIR
Last Name:DOANE
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 1:353 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84103-1624
Mailing Address - Country:US
Mailing Address - Phone:810-449-4061
Mailing Address - Fax:
Practice Address - Street 1:6272 S HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84121-2126
Practice Address - Country:US
Practice Address - Phone:810-449-4061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12912683-17011835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist