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Individual

MRS. CYNTHIA LOUISE GOLLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPTH

Contact information

Practice address
901 SW EMIGRANT AVE, PENDLETON, OR 97801-1948
(541) 276-7909
(541) 276-2101
Mailing address
901 SE EMIGRANT AVE., PENDLETON, OR 97801
(541) 276-7909
(541) 276-2101

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
CPT-0000608
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CPT-0000608
STATE PHARMACIST LICENSE
OR
Enumeration date
02/27/2012
Last updated
02/27/2012
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