Provider Demographics
NPI:1073657359
Name:CARR, WENDI L (RPH)
Entity Type:Individual
Prefix:MRS
First Name:WENDI
Middle Name:L
Last Name:CARR
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:PO BOX 2153
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-4153
Mailing Address - Country:US
Mailing Address - Phone:360-415-6700
Mailing Address - Fax:360-415-6702
Practice Address - Street 1:5455 ALMIRA DR SE
Practice Address - Street 2:SUITE 329
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98311-8330
Practice Address - Country:US
Practice Address - Phone:360-415-6700
Practice Address - Fax:360-415-6702
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA41154183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist