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NPI Code Detail

MEDICARE: KATHRYN MARIE LEWIS KOVEN PHARMD

MEDICARE: KATHRYN MARIE LEWIS KOVEN PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P1200XPharmacotherapy Pharmacist7636SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17636OTHERSCSTATE PHARMACY LICENSE

General Provider Information

NPI Number : 1407840929
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN MARIE LEWIS KOVEN PHARMD
Provider Business Mailing Address
First Line : 2603 HARRIS AVE
Second Line :
City : RICHLAND
State : WA
Zip : 99354-1639
Country : US
Telephone Number : 509-554-1862
Fax Number : 509-527-6137
Provider Business Practice Location Address
First Line : 77 WAINWRIGHT DR
Second Line : JM WAINWRIGHT VAMC
City : WALLA WALLA
State : WA
Zip : 99362-3975
Country : US
Telephone Number : 509-525-5200
Fax Number : 509-527-6137
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2005
Last Update Date : 07/08/2007

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