Thayne Edward Vickstrom
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 StCorvallis, OR 97333-2630
Phone: (541) 758-3392
Fax: (541) 758-4159
Show map & directions
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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 number | 1265705768 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | February 14, 2012 |
| Last updated in NPPES | February 14, 2012 |
| Mailing address | 1555 Sw 53rd St, Corvallis, OR 97333-2630 |
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