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NPI Code Detail

MEDICARE: KRISTA FOBERT PHARMD

MEDICARE: KRISTA FOBERT PHARMD
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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistRPH0014138OR
2183500000XPharmacistRPH-0014138OR
31835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistRPH-0014138OR

General Provider Information

NPI Number : 1851775100
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTA FOBERT PHARMD
Provider Business Mailing Address
First Line : PO BOX 190
Second Line :
City : TOPPENISH
State : WA
Zip : 98948-0190
Country : US
Telephone Number : 509-865-2395
Fax Number : 509-865-0757
Provider Business Practice Location Address
First Line : 1175 MOUNT HOOD AVE
Second Line :
City : WOODBURN
State : OR
Zip : 97071-9060
Country : US
Telephone Number : 503-982-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2015
Last Update Date : 06/11/2026

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