Provider Demographics
NPI:1962956375
Name:WRIGHT, KATELYN BECK (RPH)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:BECK
Last Name:WRIGHT
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 1:22800 W BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-8261
Mailing Address - Country:US
Mailing Address - Phone:503-442-5914
Mailing Address - Fax:
Practice Address - Street 1:25900 SW HEATHER PL
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-5785
Practice Address - Country:US
Practice Address - Phone:503-825-4005
Practice Address - Fax:503-825-4023
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0015450183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist