Provider Demographics
NPI:1174928105
Name:WARD, REBECCA MARIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:MARIE
Last Name:WARD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1284 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-3227
Mailing Address - Country:US
Mailing Address - Phone:360-683-9453
Mailing Address - Fax:360-683-9793
Practice Address - Street 1:1284 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3227
Practice Address - Country:US
Practice Address - Phone:360-683-9453
Practice Address - Fax:360-683-9793
Is Sole Proprietor?:No
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60173388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist