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General NPI Number Information
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NPI Number | 1487331278
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Entity Type | Individual
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Provider Name | ELINA GOUW PEDERSON RPH
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Gender | Female
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Dates
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Enumeration Date | 07/03/2023
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 2500 SANTIAM HWY SE
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City | ALBANY
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State | OR
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Zip | 97322-5265
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Country | US
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Telephone | 541-967-6730
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Fax |
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Provider Business Mailing Address
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Address Line | 33624 SPRINGER RD
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City | PHILOMATH
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State | OR
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Zip | 97370-9718
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Country | US
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Telephone | 503-484-7048
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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 | 0020256
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License Number State | OR
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