Individual
JAMES DOUGLAS BANNISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1501 BAY AVE, OCEAN PARK, WA 98640
(360) 665-6137
(360) 665-6264
Mailing address
3307 224TH LN, LONG BEACH, WA 98631-7302
(360) 665-2457
(360) 665-6264
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH019130
WA
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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