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1962951103
MARISKA S WIDHARMA
CORVALLIS, OR
NPI
1962951103
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: OR RPH-0015626)
Enumeration Date
2016-09-29
Last Update Date
2016-09-29
Business Address
Dr. MARISKA S WIDHARMA PharmD
3600 NW SAMARITAN DR INPATIENT PHARMACY
CORVALLIS, OR 97330-3737
Phone number: 541-768-5071
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Mailing Address
Dr. MARISKA S WIDHARMA PharmD
3156 NW MORNING GLORY DR
CORVALLIS, OR 97330-3466
Phone number: 541-760-5568
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