Provider Demographics
NPI:1073943502
Name:MITO, DANICA (PHARMD)
Entity Type:Individual
Prefix:
First Name:DANICA
Middle Name:
Last Name:MITO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 S MILLER ST
Mailing Address - Street 2:CENTRAL WASHINGTON HOSPITAL INPATIENT PHARMACY
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-3201
Mailing Address - Country:US
Mailing Address - Phone:509-661-3513
Mailing Address - Fax:509-665-6213
Practice Address - Street 1:1201 S MILLER ST
Practice Address - Street 2:CENTRAL WASHINGTON HOSPITAL INPATIENT PHARMACY
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-3201
Practice Address - Country:US
Practice Address - Phone:509-661-3513
Practice Address - Fax:509-665-6213
Is Sole Proprietor?:No
Enumeration Date:2013-11-19
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00045215183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist