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General NPI Number Information
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NPI Number | 1245814185
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Entity Type | Individual
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Provider Name | REBECCA WARNKE IMMUNIZER
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Gender | Female
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Dates
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Enumeration Date | 05/06/2021
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Last Update Date | 05/06/2021
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Provider Practice Location Address
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Address Line | 2860 NW BUCKLIN HILL RD
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City | SILVERDALE
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State | WA
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Zip | 98383-8513
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Country | US
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Telephone | 360-692-3410
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Fax |
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Provider Business Mailing Address
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Address Line | 8182 NW LAWSTAD PL
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City | SILVERDALE
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State | WA
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Zip | 98383-9043
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Country | US
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Telephone | 360-362-3681
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | VA00016843
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License Number State | WA
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