Mariska S Widharma, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

RPH-0015626 Issued in OR

Practice address

3600 NW Samaritan Dr
Inpatient Pharmacy
Corvallis, OR 97330-3737

Phone

(541) 768-5071

NPI assigned

Sep 29, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475107200000",
    "number": "1962951103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3156 NW MORNING GLORY DR",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303466",
            "telephone_number": "541-760-5568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 NW SAMARITAN DR",
            "address_2": "INPATIENT PHARMACY",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973303737",
            "telephone_number": "541-768-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDHARMA",
        "first_name": "MARISKA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-29",
        "last_updated": "2016-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0015626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Edward Whitney, LCSW
• Michael A Whitten
• Selena Whittle, PHD, MS, LPC
• Whole Life Healthy
• Margaret Catherine Wickham, LMT
• Gail Wiebe, PMHNP
• Kaitlin Wiegand
• Melanie Wiens
• Lloyd Harvey Wiggins, MD
• Tara M Wikert

• Pharmacist in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Pharmacist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.