IndividualActive
Andrew Vanderwall
NPI 1912375825 · Pharmacist · Independence, OR
Provider details
- NPI number
- 1912375825
- Entity type
- Individual
- Primary specialty
- PharmacistPharmacy Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- RPH-0014885 (OR)
Specialties & taxonomies
Pharmacy Service Providers
Pharmacy Service Providers
Practice location
1357 Monmouth St
Independence, OR 97351-1126
Phone: (503) 838-2195
Fax: (503) 838-3129
Approximate (ZIP-level) locationGet directions
Mailing address
916 W Evergreen Blvd
Vancouver, WA 98660-3035
Registry dates
- Enumerated
- 2015-09-09
- Last updated
- 2016-01-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.