Healthcare Provider Details

I. General information

NPI: 1598111981
Provider Name (Legal Business Name): KATHRYN H EDMISTON RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN MURPHY

II. Dates (important events)

Enumeration Date: 05/04/2016
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46314 TIMINE WAY
PENDLETON OR
97801
US

IV. Provider business mailing address

46314 TIMINE WAY
PENDLETON OR
97801
US

V. Phone/Fax

Practice location:
  • Phone: 541-966-9830
  • Fax: 541-278-7568
Mailing address:
  • Phone: 541-966-9830
  • Fax: 541-278-7568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH-0008903-P
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: