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General NPI Number Information
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NPI Number | 1033649256
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Entity Type | Individual
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Provider Name | SEAN COLLINS
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Gender | Male
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Dates
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Enumeration Date | 06/20/2017
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Last Update Date | 03/25/2021
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Provider Practice Location Address
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Address Line | 401 BUSTER RD
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City | TOPPENISH
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State | WA
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Zip | 98948-9792
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Country | US
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Telephone | 509-865-1703
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Fax | 509-865-8753
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Provider Business Mailing Address
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Address Line | 3016 S HARRISON ST
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City | KENNEWICK
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State | WA
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Zip | 99338-2044
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Country | US
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Telephone | 406-461-6852
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHA-PHA-LIC-51219
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH60831339
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License Number State | WA
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