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General NPI Number Information
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NPI Number | 1952887184
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Entity Type | Individual
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Provider Name | RYNE WATANABE
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Gender | Male
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Dates
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Enumeration Date | 07/11/2018
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Last Update Date | 07/11/2018
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Provider Practice Location Address
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Address Line | 2320 23RD ST
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City | COLUMBUS
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State | NE
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Zip | 68601-3304
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Country | US
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Telephone | 402-563-3588
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Fax |
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Provider Business Mailing Address
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Address Line | 7403 NINA ST APT 206
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City | OMAHA
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State | NE
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Zip | 68124-8423
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Country | US
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Telephone | 808-753-2850
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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 | 15445
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License Number State | NE
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