Individual
MR. DOUGLAS EDWARD WITZKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH
Contact information
Practice address
930 SW ABBEY ST, NEWPORT, OR 97365-4820
(541) 574-4840
Mailing address
8553 NW OAK CREEK DR, CORVALLIS, OR 97330-2749
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8459
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH-8459
PHARMACY LICENSE
OR
Enumeration date
10/01/2019
Last updated
10/01/2019
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