Individual
DR. MARISKA S WIDHARMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
3600 NW SAMARITAN DR, INPATIENT PHARMACY, CORVALLIS, OR 97330-3737
(541) 768-5071
Mailing address
3156 NW MORNING GLORY DR, CORVALLIS, OR 97330-3466
(541) 760-5568
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0015626
OR
Other
Enumeration date
09/29/2016
Last updated
09/29/2016
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