Organization
DEMAREST INC
Active
Other names
Colton Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY SHANE HARRELL PHARMD (OWNER)
(360) 859-8659
Entity
Organization
Contact information
Practice address
100 WESTLAKE AVE, MORTON, WA 98356-5502
(360) 496-5902
(360) 496-3215
Mailing address
PO BOX B, ILWACO, WA 98624-0167
(360) 496-5902
(360) 496-3215
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.00056017
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1042842
—
WA
01
—
2106834
PK
—
Enumeration date
09/06/2006
Last updated
12/20/2025
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