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General NPI Number Information
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NPI Number | 1306145594
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Entity Type | Individual
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Provider Name | AMY E DELIA RPH
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Gender | Female
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Dates
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Enumeration Date | 03/28/2011
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Last Update Date | 03/10/2014
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Provider Practice Location Address
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Address Line | 808 W MAIN ST
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City | BATTLE GROUND
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State | WA
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Zip | 98604-9136
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Country | US
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Telephone | 360-687-5186
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Fax |
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Provider Business Mailing Address
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Address Line | 2009 NE HANCOCK ST
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City | PORTLAND
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State | OR
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Zip | 97212-4564
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Country | US
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Telephone | 360-953-0190
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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 | PH60112490
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2009011858
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH-0013976
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License Number State | OR
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