Provider Demographics
NPI:1205225943
Name:AMERINE, MARGEAUX (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARGEAUX
Middle Name:
Last Name:AMERINE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31490 STATE ROUTE 20
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-3117
Mailing Address - Country:US
Mailing Address - Phone:360-675-3497
Mailing Address - Fax:360-675-8453
Practice Address - Street 1:31490 STATE ROUTE 20
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-3117
Practice Address - Country:US
Practice Address - Phone:360-675-3497
Practice Address - Fax:360-675-8453
Is Sole Proprietor?:No
Enumeration Date:2015-01-19
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60129626183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist