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General NPI Number Information
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NPI Number | 1154758811
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Entity Type | Individual
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Provider Name | KRISTINA MADRIGAL PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/26/2013
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Last Update Date | 02/10/2014
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Provider Practice Location Address
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Address Line | 2700 SE STRATUS AVE
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City | MCMINNVILLE
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State | OR
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Zip | 97128-6255
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Country | US
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Telephone | 503-472-6540
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Fax |
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Provider Business Mailing Address
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Address Line | 2295 SW BARBER LN
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City | MCMINNVILLE
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State | OR
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Zip | 97128-8943
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Country | US
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Telephone |
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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 | 0013755
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License Number State | OR
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