Provider Demographics
NPI:1255920658
Name:KRUGER, REGINA ELIZABETH (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:REGINA
Middle Name:ELIZABETH
Last Name:KRUGER
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2195 NW JACKSON CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-9664
Mailing Address - Country:US
Mailing Address - Phone:347-351-8634
Mailing Address - Fax:
Practice Address - Street 1:590 NE CIRCLE BLVD
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-6828
Practice Address - Country:US
Practice Address - Phone:541-753-1547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13998-040183500000X
OR0017831183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist