Doctor Name: | BROOK HENNEFER |
NPI Number: | 1306823026 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | VA00052418 |
Business Practice Address: | 22117 Se 237th St Maple Valley, WA - 980388533 |
Business Phone Number: | 4254321234 |
Business Fax Number: | 4254326756 |
Mailing Address: | 18303 107th Street Ct E, BONNEY LAKE |
State: | WA |
Postal Code: | 983916056 |
Phone Number: | 2538266689 |
Fax Number: | |
NPI Enumeration Date: | 12/22/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 183700000X |
License Number: | VA00052418 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Pharmacy Service Providers |
Taxonomy Classification: | Pharmacy Technician |
Taxonomy Specialization: | |
Taxonomy Definition: | A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |