Provider Demographics
NPI:1487912937
Name:HARTZELL, RHONDA SUZANN (RPH)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:SUZANN
Last Name:HARTZELL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 CASCADE KY
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-1023
Mailing Address - Country:US
Mailing Address - Phone:425-641-0909
Mailing Address - Fax:
Practice Address - Street 1:53 CASCADE KY
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1023
Practice Address - Country:US
Practice Address - Phone:425-641-0909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00013816183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist