Individual
KRISTI STANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
215 E ROSE ST, WALLA WALLA, WA 99362-1216
(541) 602-1213
Mailing address
215 E ROSE ST, WALLA WALLA, WA 99362-1216
(541) 602-1213
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH61209790
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH61209790
PHARMACIST LICENSE
WA
Enumeration date
10/29/2021
Last updated
10/29/2021
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