Organization
OKANOGAN VALLEY PROFESSIONAL PHARMACY LLC
Active
Organization
OKANOGAN VALLEY PROFESSIONAL PHARMACY LLC
Active
Other names
Okanogan Valley Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TRENT DANIELSON PHARMD (OWNER)
(509) 322-6321
Entity
Organization
Contact information
Practice address
236 N. 2ND AVE., OKANOGAN, WA 98840
(509) 422-9958
(509) 422-9998
Mailing address
PO BOX 1247, OKANOGAN, WA 98840-1247
(509) 422-9958
(509) 422-9998
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.60427458
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2035201
—
WA
01
—
2142898
PK
—
Enumeration date
02/10/2012
Last updated
08/12/2016
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