Provider Demographics
NPI:1073876447
Name:RICHARD, NORMAND J (RPH)
Entity Type:Individual
Prefix:MR
First Name:NORMAND
Middle Name:J
Last Name:RICHARD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14300 NE 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-6420
Mailing Address - Country:US
Mailing Address - Phone:360-576-4844
Mailing Address - Fax:
Practice Address - Street 1:14300 NE 20TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686-6420
Practice Address - Country:US
Practice Address - Phone:360-576-4844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60075068183500000X
ORRPH-0012955183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA60075068OtherSTATE BOARD OF PHARMACY