Healthcare Provider Details

I. General information

NPI: 1962614578
Provider Name (Legal Business Name): RAYMOND UNITED DRUG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 WILLAPA PLACE
RAYMOND WA
98577
US

IV. Provider business mailing address

PO BOX 669 707 WILLAPA PLACE
RAYMOND WA
98577
US

V. Phone/Fax

Practice location:
  • Phone: 360-942-2153
  • Fax: 360-942-2939
Mailing address:
  • Phone: 360-942-2153
  • Fax: 360-942-2939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberCF00001111
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00009276
License Number StateWA

VIII. Authorized Official

Name: MR. RONALD GENE BRUMMEL
Title or Position: PHARMACIST OWNER
Credential: RPH
Phone: 360-942-2153