Healthcare Provider Details

I. General information

NPI: 1629497961
Provider Name (Legal Business Name): KRISTI ANN NEWTON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 03/09/2022
Certification Date: 03/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6720 NE 84TH ST
VANCOUVER WA
98665-2016
US

IV. Provider business mailing address

6720 NE 84TH ST
VANCOUVER WA
98665-2016
US

V. Phone/Fax

Practice location:
  • Phone: 360-828-2289
  • Fax: 360-828-2286
Mailing address:
  • Phone: 360-828-2289
  • Fax: 360-828-2286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60468075
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH60468075
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: