Provider Demographics
NPI:1215530134
Name:MCDONALD, VICTORIA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:REICHERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3490 S 4400 W STE 702003
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-1828
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3490 S 4400 W STE 702003
Practice Address - Street 2:
Practice Address - City:WEST VALLEY CITY
Practice Address - State:UT
Practice Address - Zip Code:84120-1828
Practice Address - Country:US
Practice Address - Phone:385-424-0549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-21
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202211583183500000X
IDP9853183500000X
UT6077794-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist