Individual
MR. JEAN WAYNE FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
207 E. 1ST ST., WALLOWA, OR 97885
(541) 886-2361
(541) 886-6801
Mailing address
PO BOX 38, WALLOWA, OR 97885-0038
(541) 886-2361
(541) 886-6801
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH 0005851
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179317
—
OR
Enumeration date
08/02/2006
Last updated
11/28/2007
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