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General NPI Number Information
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NPI Number | 1083138069
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Entity Type | Individual
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Provider Name | JOHN ERIK RICHARDSON I PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 08/01/2017
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Provider Practice Location Address
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Address Line | 2519 MAIN ST
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City | UNION GAP
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State | WA
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Zip | 98903-1605
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Country | US
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Telephone | 509-453-3603
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Fax |
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Provider Business Mailing Address
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Address Line | 208 N 41ST ST UNIT B
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City | YAKIMA
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State | WA
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Zip | 98901-1290
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Country | US
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Telephone | 360-500-3798
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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 | PH60748106
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License Number State | WA
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