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NPI 1366885691

NPI 1366885691 : LESLIE-ANN FOX I RPH : ELLENSBURG, WA

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General NPI Number Information
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    NPI Number           |    1366885691
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    Entity Type          |    Individual 
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    Provider Name        |    LESLIE-ANN FOX I RPH
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/17/2013
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    Last Update Date     |    04/17/2013
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Provider Practice Location Address
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    Address Line         |    521 EAST MOUNTAIN VIEW AVE 
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    City                 |    ELLENSBURG
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    State                |    WA
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    Zip                  |    98926
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    Country              |    US
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    Telephone            |    509-649-2340
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 585 
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    City                 |    ROSLYN
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    State                |    WA
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    Zip                  |    98941
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    Country              |    US
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    Telephone            |    509-649-2340
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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       |    PH0015610
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    License Number State |    WA
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