Individual
KARIE G GEDEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMACY CPHT
Contact information
Practice address
1370 WASHINGTON AVE, COOS BAY, OR 97420-1031
(541) 267-2014
Mailing address
1775 THOMPSON RD, COOS BAY, OR 97420-2125
(541) 269-8160
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
CPT-0000947
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CPT-0000947
OREGON BOARD OF PHARMACY
OR
Enumeration date
09/28/2006
Last updated
07/08/2007
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