Individual
ROBERT BRENT WATERS
Active
Individual
ROBERT BRENT WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
PH00011060
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003118
L&I
WA
05
—
6010938
—
WA
01
—
91-1996749
TAX ID
WA
Enumeration date
08/04/2006
Last updated
11/29/2017
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