IndividualActive
Carly Gostanian
NPI 1740776319 · Pharmacy · Keizer, OR
Provider details
- NPI number
- 1740776319
- Entity type
- Individual
- Primary specialty
- PharmacySuppliers
- Sex
- Female
- Sole proprietor
- Yes
- License
- PI-0012993 (OR)
Mailing address
4010 Nw Witham Hill Dr Apt 123
Corvallis, OR 97330-1648
Registry dates
- Enumerated
- 2018-07-07
- Last updated
- 2018-07-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.