Healthcare Provider Details

I. General information

NPI: 1659131118
Provider Name (Legal Business Name): RACHEL JACQUELINE FREMAULT PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

339 FERRY ST
SEDRO WOOLLEY WA
98284-1412
US

IV. Provider business mailing address

2605 FIR CREST BLVD
ANACORTES WA
98221-8753
US

V. Phone/Fax

Practice location:
  • Phone: 360-853-2003
  • Fax:
Mailing address:
  • Phone: 339-222-0885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH61490140
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: