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General NPI Number Information
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NPI Number | 1497648745
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Entity Type | Individual
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Provider Name | DR. STACI LYNETTE OGDEN
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Gender | Female
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Dates
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Enumeration Date | 06/03/2025
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 20403 OLD HIGHWAY 9 SW
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City | CENTRALIA
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State | WA
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Zip | 98531-7915
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Country | US
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Telephone | 360-664-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 1295 FERRIER RD
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City | WINLOCK
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State | WA
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Zip | 98596-9330
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Country | US
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Telephone | 360-703-1328
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Fax | 360-703-1328
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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 | PH00051099
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License Number State | WA
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