Organization
CREDENA HEALTH LLC
Active
Other names
Credena Health Pharmacy Monroe
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE SKAFI (AVP/SECRETARY)
(575) 650-3396
Entity
Organization
Contact information
Practice address
19200 N KELSEY STREET, MONROE, WA 98272
(360) 794-5555
(360) 805-4797
Mailing address
PO BOX 2704, PORTLAND, OR 97208-2704
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2108111
PK
—
Enumeration date
10/18/2005
Last updated
12/05/2023
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