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General NPI Number Information
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NPI Number | 1336033786
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Entity Type | Individual
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Provider Name | ANNA EDWARDS
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Gender | Female
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 1601 SW JEFFERSON AVE
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City | CORVALLIS
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State | OR
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Zip | 97331-8656
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Country | US
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Telephone | 541-737-3424
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Fax |
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Provider Business Mailing Address
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Address Line | 6424 PAINT HORSE WAY
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City | KLAMATH FALLS
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State | OR
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Zip | 97601-9286
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Country | US
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Telephone | 541-891-1512
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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 | PI-0014568
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License Number State | OR
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