Provider Demographics
NPI:1578679569
Name:WHITE, RAINA L (RPH)
Entity Type:Individual
Prefix:MRS
First Name:RAINA
Middle Name:L
Last Name:WHITE
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 1:918 SW HIGGINS AVE
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-3606
Mailing Address - Country:US
Mailing Address - Phone:406-549-4125
Mailing Address - Fax:406-549-8310
Practice Address - Street 1:918 SW HIGGINS AVE
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-3606
Practice Address - Country:US
Practice Address - Phone:406-549-4125
Practice Address - Fax:406-549-8310
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3997183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist