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General NPI Number Information
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NPI Number | 1437567120
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Entity Type | Individual
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Provider Name | AHNRA KIM PHARMACIST
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Gender | Female
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Dates
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Enumeration Date | 07/26/2014
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 430 SE 192ND AVE WALMART PHARMACY
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City | VANCOUVER
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State | WA
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Zip | 98683-9531
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Country | US
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Telephone | 360-256-6361
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Fax | 360-256-6378
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Provider Business Mailing Address
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Address Line | 1201 SW 13TH AVE
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City | BATTLE GROUND
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State | WA
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Zip | 98604-2800
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Country | US
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Telephone | 360-723-9007
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Fax | 360-687-8192
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | RPH-0012695
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH00067873
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License Number State | WA
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