Healthcare Provider Details

I. General information

NPI: 1487053229
Provider Name (Legal Business Name): KATHRYN HAPROFF PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN BEHREND PHARMD

II. Dates (important events)

Enumeration Date: 08/18/2014
Last Update Date: 08/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

914 S SCHEUBER RD
CENTRALIA WA
98531-9027
US

IV. Provider business mailing address

914 S SCHEUBER RD
CENTRALIA WA
98531-9027
US

V. Phone/Fax

Practice location:
  • Phone: 360-736-2803
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH60102060
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: