Provider Demographics
NPI:1124235577
Name:SELINGER, RAQUEL (RPH)
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:SELINGER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CRESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-6929
Mailing Address - Country:US
Mailing Address - Phone:707-616-3356
Mailing Address - Fax:707-441-2065
Practice Address - Street 1:529 I ST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-1116
Practice Address - Country:US
Practice Address - Phone:707-268-2162
Practice Address - Fax:707-441-2065
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44911183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist