Provider Demographics
NPI:1992246300
Name:DELA CRUZ, MARGERY ROXANE
Entity type:Individual
Prefix:
First Name:MARGERY ROXANE
Middle Name:
Last Name:DELA CRUZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 453
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:WA
Mailing Address - Zip Code:98595-0453
Mailing Address - Country:US
Mailing Address - Phone:360-268-0505
Mailing Address - Fax:360-268-1302
Practice Address - Street 1:733 N MONTESANO ST
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:WA
Practice Address - Zip Code:98595-0385
Practice Address - Country:US
Practice Address - Phone:360-268-0505
Practice Address - Fax:360-268-1302
Is Sole Proprietor?:No
Enumeration Date:2017-03-17
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60713321183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist