Provider Demographics
NPI:1508130733
Name:RIPER, EDITH
Entity Type:Individual
Prefix:MRS
First Name:EDITH
Middle Name:
Last Name:RIPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695 S HIGHWAY 101
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:OR
Mailing Address - Zip Code:97146-9319
Mailing Address - Country:US
Mailing Address - Phone:503-861-3033
Mailing Address - Fax:503-861-3020
Practice Address - Street 1:695 S HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:OR
Practice Address - Zip Code:97146-9319
Practice Address - Country:US
Practice Address - Phone:503-861-3033
Practice Address - Fax:503-861-3020
Is Sole Proprietor?:No
Enumeration Date:2012-03-06
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR12254183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist