Provider Demographics
NPI:1093194029
Name:WOFFORD, MICHELE MAHEALANI (RPH)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:MAHEALANI
Last Name:WOFFORD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 305
Mailing Address - Street 2:
Mailing Address - City:WALTERVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97489-0305
Mailing Address - Country:US
Mailing Address - Phone:541-255-5633
Mailing Address - Fax:
Practice Address - Street 1:1990 14TH AVE SE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97322-8504
Practice Address - Country:US
Practice Address - Phone:541-812-2386
Practice Address - Fax:541-812-2388
Is Sole Proprietor?:No
Enumeration Date:2015-05-22
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-00159251835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist