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General NPI Number Information
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NPI Number | 1255602728
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Entity Type | Individual
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Provider Name | BRYAN JOHN KNOBEL PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 01/15/2012
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Last Update Date | 01/15/2012
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Provider Practice Location Address
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Address Line | 6708 NE 63RD ST
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City | VANCOUVER
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State | WA
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Zip | 98661-1915
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Country | US
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Telephone | 360-696-0750
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Fax | 360-567-1679
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Provider Business Mailing Address
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Address Line | 4306 NE 62ND AVE
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City | VANCOUVER
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State | WA
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Zip | 98661-3028
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Country | US
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Telephone | 360-993-1107
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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 | PO00019906
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License Number State | WA
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