Individual
REVATI PATEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2865 DAGGETT AVE, KLAMATH FALLS, OR 97601-1106
(541) 274-3784
(541) 274-3777
Mailing address
2169 N ELDORADO AVE APT 7, KLAMATH FALLS, OR 97601-6433
(971) 219-7173
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0012386
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0012386
PHARMACIST LICENSE
OR
Enumeration date
08/03/2018
Last updated
08/03/2018
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