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General NPI Number Information
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NPI Number | 1104635143
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Entity Type | Individual
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Provider Name | AUDREY NEWR EDLER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/03/2025
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 4300 NE 4TH ST
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City | RENTON
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State | WA
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Zip | 98059-5008
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Country | US
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Telephone | 425-873-2091
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Fax |
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Provider Business Mailing Address
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Address Line | 3788 NE 4TH ST APT H203
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City | RENTON
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State | WA
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Zip | 98056-8486
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Country | US
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Telephone | 509-559-9520
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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 | PH61590857
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License Number State | WA
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