Individual
ELIZABETH M WAIGUCHU JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD, RPH
Contact information
Practice address
703 NE HANCOCK ST, PORTLAND, OR 97212-3955
(971) 386-2062
(503) 230-9877
Mailing address
PO BOX 1569, PORTLAND, OR 97207-1569
(503) 224-1044
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0011663
OR
Other
Enumeration date
07/20/2011
Last updated
02/27/2026
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