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NPI Code Detail

MEDICARE: MR. RYAN MICHAEL WIMMERS RPH

MEDICARE: MR. RYAN MICHAEL WIMMERS RPH
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
1183500000XPharmacistPH00063815WA

General Provider Information

NPI Number : 1780958728
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RYAN MICHAEL WIMMERS RPH
Provider Business Mailing Address
First Line : 7700 NE HIGHWAY 99
Second Line :
City : VANCOUVER
State : WA
Zip : 98665-8872
Country : US
Telephone Number : 360-699-8133
Fax Number :
Provider Business Practice Location Address
First Line : 7700 NE HIGHWAY 99
Second Line :
City : VANCOUVER
State : WA
Zip : 98665-8872
Country : US
Telephone Number : 360-699-8133
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2012
Last Update Date : 02/22/2016

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