Healthcare Provider Details

I. General information

NPI: 1124797683
Provider Name (Legal Business Name): EASTON J STONER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2021
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2690 NE KRESKY AVE
CHEHALIS WA
98532-2412
US

IV. Provider business mailing address

2690 NE KRESKY AVE
CHEHALIS WA
98532-2412
US

V. Phone/Fax

Practice location:
  • Phone: 360-669-0600
  • Fax: 360-669-0602
Mailing address:
  • Phone: 360-330-9595
  • Fax: 360-330-9560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number61176315
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: