Provider Demographics
NPI:1811373772
Name:RIDGE, KATRIN M (RPH)
Entity Type:Individual
Prefix:
First Name:KATRIN
Middle Name:M
Last Name:RIDGE
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 1:1010 7TH AVE. SW.
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:OR
Mailing Address - Zip Code:97321
Mailing Address - Country:US
Mailing Address - Phone:541-812-5070
Mailing Address - Fax:541-812-5077
Practice Address - Street 1:1010 7TH AVE. SW.
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321
Practice Address - Country:US
Practice Address - Phone:541-812-5070
Practice Address - Fax:541-812-5077
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-00096761835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist