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General NPI Number Information
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NPI Number | 1770939019
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Entity Type | Organization
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Legal Business Name | NORTHWEST CANCER SPECIALISTS PC
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 11/18/2016
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Provider Practice Location Address
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Address Line | 1498 SE TECH CENTER PL STE 240 ATTN: PHARMACY DEPARTMENT
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City | VANCOUVER
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State | WA
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Zip | 98683-5508
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Country | US
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Telephone | 360-597-1070
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Fax | 360-597-1371
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Provider Business Mailing Address
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Address Line | 1498 SE TECH CENTER PL STE 240 ATTN: PHARMACY DEPARTMENT
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City | VANCOUVER
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State | WA
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Zip | 98683-5508
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Country | US
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Telephone | 360-597-1070
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Fax | 360-597-1371
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Authorized Official
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Title or Position | PHARMACY MANAGER/PIC/AO
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Name | JAMIE FRITZ
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Credential | RPH
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Telephone | 360-597-1070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHAR.CF.60664565
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License Number State | WA
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