Provider Demographics
NPI:1043297609
Name:MORSE, DONOVAN LEE (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:DONOVAN
Middle Name:LEE
Last Name:MORSE
Suffix:
Gender:M
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2432
Mailing Address - Street 2:
Mailing Address - City:BELFAIR
Mailing Address - State:WA
Mailing Address - Zip Code:98528-2432
Mailing Address - Country:US
Mailing Address - Phone:360-277-0996
Mailing Address - Fax:
Practice Address - Street 1:5500 OLYMPIC DR
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1487
Practice Address - Country:US
Practice Address - Phone:253-858-7455
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA00039475183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician