Healthcare Provider Details
I. General information
NPI: 1306111661
Provider Name (Legal Business Name): RENAY DAWN HILLMAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/19/2012
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
835 SE BISHOP BLVD
PULLMAN WA
99163-5512
US
IV. Provider business mailing address
920 SW PANORAMA DR
PULLMAN WA
99163-5968
US
V. Phone/Fax
- Phone: 509-432-4426
- Fax:
- Phone: 509-432-4426
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | PH00072327 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: