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General NPI Number Information
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NPI Number | 1134762925
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Entity Type | Individual
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Provider Name | LINARIA KITCHEN
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Gender | Female
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Dates
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Enumeration Date | 10/23/2019
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Last Update Date | 10/23/2019
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Provider Practice Location Address
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Address Line | 7591 CRATER LAKE HWY # A
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City | WHITE CITY
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State | OR
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Zip | 97503-1663
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Country | US
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Telephone | 541-826-4414
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Fax |
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Provider Business Mailing Address
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Address Line | 1310 N MOUNTAIN AVE
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City | ASHLAND
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State | OR
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Zip | 97520-9392
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Country | US
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Telephone | 541-778-8065
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH-0017356
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License Number State | OR
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