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Individual

MRS. CHRISTY WAGGONER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
1775 E IDAHO AVE, ONTARIO, OR 97914
(541) 889-6040
Mailing address
5108 CLEVELAND BLVD, CALDWELL, ID 83607-8002
(208) 455-0800
(208) 455-3539

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
P5368
ID
183500000X
Pharmacist
RPH-0012207
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RPH-0012207
OR

Other

Enumeration date
08/12/2014
Last updated
07/05/2018
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