MEDICARE: MEGAN JOAQUIN RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH-0019355	OR

General Provider Information

NPI Number	:	1144920653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN JOAQUIN RPH

Provider Business Mailing Address
First Line	:	11265 SW DAVIES RD APT 1103
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97007-7687
Country	:	US
Telephone Number	:	808-203-3100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1755 IVY ST
Second Line	:
City	:	JUNCTION CITY
State	:	OR
Zip	:	97448-2017
Country	:	US
Telephone Number	:	541-998-4526
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2023
Last Update Date	:	03/06/2023

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