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General NPI Number Information
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NPI Number | 1316142557
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Entity Type | Individual
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Provider Name | JAMES SCOTT EASTON III
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Gender | Male
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 810 S. MAIN
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City | DEER PARK
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State | WA
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Zip | 99006
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Country | US
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Telephone | 509-276-2939
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 841 121 N. CRAIG ST.
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City | NEWPORT
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State | WA
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Zip | 99156-0841
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Country | US
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Telephone | 509-447-5841
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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 | PH00009115
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License Number State | WA
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