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NPI Code Detail

MEDICARE: MARJORIE BLAINE PHARMD

MEDICARE:   MARJORIE  BLAINE  PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPH60040240WA

General Provider Information

NPI Number : 1952719833
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARJORIE BLAINE PHARMD
Provider Business Mailing Address
First Line : 1250 SW ERIE ST
Second Line :
City : OAK HARBOR
State : WA
Zip : 98277-3103
Country : US
Telephone Number : 360-279-0671
Fax Number : 360-279-2421
Provider Business Practice Location Address
First Line : 1250 SW ERIE ST
Second Line :
City : OAK HARBOR
State : WA
Zip : 98277-3103
Country : US
Telephone Number : 360-279-0671
Fax Number : 360-279-2421
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2014
Last Update Date : 07/23/2014

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Directions to “ MARJORIE BLAINE PHARMD” Practice Location

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