Healthcare Provider Details

I. General information

NPI: 1851632889
Provider Name (Legal Business Name): IAN BARNES PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2013
Last Update Date: 03/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 IRONDALE RD
PORT HADLOCK WA
98339-9582
US

IV. Provider business mailing address

72 CARLI CT
PORT TOWNSEND WA
98368-9100
US

V. Phone/Fax

Practice location:
  • Phone: 360-385-1900
  • Fax:
Mailing address:
  • Phone: 513-314-1826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60230120
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: