Individual
AMANDA MICHELLE WAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
830 3RD ST, SAN RAFAEL, CA 94901-3302
(415) 455-9919
Mailing address
11 RACCOON DR, NOVATO, CA 94949-6683
(415) 462-8032
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH51239
CA
Other
Enumeration date
09/05/2011
Last updated
09/05/2011
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