Provider Demographics
NPI:1801159132
Name:RIGGLE, ELDON LEE (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:ELDON
Middle Name:LEE
Last Name:RIGGLE
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 RIVERVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-1967
Mailing Address - Country:US
Mailing Address - Phone:509-758-8213
Mailing Address - Fax:509-758-2049
Practice Address - Street 1:400 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-1931
Practice Address - Country:US
Practice Address - Phone:509-758-7475
Practice Address - Fax:509-758-2049
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00007869183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist