Provider Demographics
NPI:1740519636
Name:MCCOY, REBECCA MEGAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:MEGAN
Last Name:MCCOY
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 1:1600 PLAZA WAY
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-4325
Mailing Address - Country:US
Mailing Address - Phone:509-522-4672
Mailing Address - Fax:509-525-8985
Practice Address - Street 1:633 W TIETAN ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-4329
Practice Address - Country:US
Practice Address - Phone:509-240-8103
Practice Address - Fax:509-529-5283
Is Sole Proprietor?:No
Enumeration Date:2009-12-23
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00069485183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist