Healthcare Provider Details

I. General information

NPI: 1407840929
Provider Name (Legal Business Name): KATHRYN MARIE LEWIS KOVEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: KATHRYN MARIE LEWIS

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 WAINWRIGHT DR JM WAINWRIGHT VAMC
WALLA WALLA WA
99362-3975
US

IV. Provider business mailing address

2603 HARRIS AVE
RICHLAND WA
99354-1639
US

V. Phone/Fax

Practice location:
  • Phone: 509-525-5200
  • Fax: 509-527-6137
Mailing address:
  • Phone: 509-554-1862
  • Fax: 509-527-6137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number7636
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: