Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Thayne Edward Vickstrom

Individual provider Pharmacist · NPI 1265705768

Thayne Edward Vickstrom is a Pharmacist in Corvallis, Oregon. Licensed in Oregon. Registered with an NPI since 2012.

Licensed in
OR
In the registry since
2012

Practice location Address checks out

1555 SW 53rd St
Corvallis, OR 97333-2630
Phone: (541) 758-3392
Fax: (541) 758-4159
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 9544 (OR)

Record details

NPI number1265705768
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 14, 2012
Last updated in NPPESFebruary 14, 2012
Mailing address1555 Sw 53rd St, Corvallis, OR 97333-2630

Other providers in Corvallis