Provider Demographics
NPI:1164543963
Name:SNIPES, ERNA OLEA (RPH)
Entity Type:Individual
Prefix:MS
First Name:ERNA
Middle Name:OLEA
Last Name:SNIPES
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 1:1505 E SECTION ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-5138
Mailing Address - Country:US
Mailing Address - Phone:360-424-6827
Mailing Address - Fax:360-424-6827
Practice Address - Street 1:1500 S BURLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98233-3220
Practice Address - Country:US
Practice Address - Phone:360-757-3772
Practice Address - Fax:360-757-3783
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00010163183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist