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General NPI Number Information
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NPI Number | 1851848469
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Entity Type | Individual
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Provider Name | ANDREA RICHARDSON
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Gender | Female
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 1330 GOLDFISH FARM RD SE
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City | ALBANY
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State | OR
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Zip | 97322-5154
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Country | US
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Telephone | 541-971-4062
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Fax |
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Provider Business Mailing Address
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Address Line | 820 8TH AVE SW
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City | ALBANY
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State | OR
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Zip | 97321
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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 | RPH-0015407
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License Number State | OR
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