Individual
RANDY NEVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPHT
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
VA60246492
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
560107010225038
CPHT CERTIFICATION NUMBER
WA
01
—
VA60246492
WA STATE CERTIFICATION NUMBER
WA
Enumeration date
09/15/2011
Last updated
09/15/2011
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