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General NPI Number Information
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NPI Number | 1558728527
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Entity Type | Individual
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Provider Name | KEVIN PATRICK WILLARD RPH
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Gender | Male
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Dates
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Enumeration Date | 01/21/2016
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Last Update Date | 01/21/2016
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Provider Practice Location Address
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Address Line | 4545 POINT FOSDICK DR NW SUITE 215
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City | GIG HARBOR
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State | WA
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Zip | 98335-1700
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Country | US
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Telephone | 253-530-8068
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Fax | 253-530-8069
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Provider Business Mailing Address
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Address Line | 4545 POINT FOSDICK DR NW SUITE 215
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City | GIG HARBOR
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State | WA
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Zip | 98335-1700
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Country | US
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Telephone | 253-530-8068
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Fax | 253-530-8069
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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 | PH 00014987
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License Number State | WA
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