Healthcare Provider Details

I. General information

NPI: 1477474716
Provider Name (Legal Business Name): MARY NICOLE DIMAANO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE DIMAANO PHARMD

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

632 CRAIG AVE
WENATCHEE WA
98801-4505
US

IV. Provider business mailing address

632 CRAIG AVE
WENATCHEE WA
98801-4505
US

V. Phone/Fax

Practice location:
  • Phone: 714-335-7327
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0207X
TaxonomyCompounded Sterile Preparations Pharmacist
License NumberPHPC.PH.60951015
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: