Provider Demographics
NPI:1104025642
Name:GRECO, JULIE ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:GRECO
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 1:205 THREE RIVERS DR
Mailing Address - Street 2:
Mailing Address - City:KELSO
Mailing Address - State:WA
Mailing Address - Zip Code:98626-3127
Mailing Address - Country:US
Mailing Address - Phone:360-578-7387
Mailing Address - Fax:360-578-7387
Practice Address - Street 1:205 THREE RIVERS DR
Practice Address - Street 2:
Practice Address - City:KELSO
Practice Address - State:WA
Practice Address - Zip Code:98626-3127
Practice Address - Country:US
Practice Address - Phone:360-578-7387
Practice Address - Fax:360-578-7387
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-14
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00070053183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist