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Individual

BRANDY MARIE WIMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1401 N 10TH AVE, STAYTON, OR 97383-1311
(503) 769-2175
Mailing address
400 NE CIRCLE BLVD, CORVALLIS, OR 97330-4290
(541) 752-3858

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0014849
OR
333600000X
Pharmacy

Other

Enumeration date
04/22/2014
Last updated
09/16/2019
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