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General NPI Number Information
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NPI Number | 1952675076
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Entity Type | Individual
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Provider Name | DEBRA KAY KELLER RPH
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Gender | Female
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Dates
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Enumeration Date | 03/07/2012
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | 412 S MAIN
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City | DEER PARK
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State | WA
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Zip | 99006
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Country | US
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Telephone | 509-276-9016
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Fax | 509-276-8890
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Provider Business Mailing Address
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Address Line | 29117 N DALTON RD
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City | DEER PARK
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State | WA
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Zip | 99006-9811
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Country | US
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Telephone | 98-637-9935
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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 | PH00018323
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License Number State | WA
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