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General NPI Number Information
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NPI Number | 1891517587
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Entity Type | Individual
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Provider Name | ASHLEY WAGNILD PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/24/2024
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 5952 BLACKSTONE WAY
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City | NINE MILE FALLS
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State | WA
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Zip | 99026-4900
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Country | US
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Telephone | 509-935-6004
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Fax |
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Provider Business Mailing Address
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Address Line | 5952 BLACKSTONE WAY
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City | NINE MILE FALLS
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State | WA
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Zip | 99026-4900
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Country | US
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Telephone |
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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 | PH61560595
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License Number State | WA
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