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Organization

WALGREENS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BETHLEHEM SHAWLE DOCTOR OF PHARMACIST (STAFF PHARMACIST)
(360) 254-3848
Entity
Organization

Contact information

Practice address
6105 NE 114TH AVE, VANCOUVER, WA 98662-6335
(360) 254-3848
Mailing address
3508 NE 109TH AVE APT T3, VANCOUVER, WA 98682-7210
(360) 254-3848

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
PH00070793
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PH00070793
PHARMACIST PHARMD
WA
Enumeration date
01/17/2012
Last updated
01/17/2012
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