Provider Demographics
NPI:1205382504
Name:KISTLER, RICHELLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RICHELLE
Middle Name:
Last Name:KISTLER
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 1:4840 JOURNEY ST SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98513-6779
Mailing Address - Country:US
Mailing Address - Phone:360-491-9770
Mailing Address - Fax:360-486-9556
Practice Address - Street 1:4840 JOURNEY ST SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98513-6779
Practice Address - Country:US
Practice Address - Phone:360-491-9770
Practice Address - Fax:360-486-9556
Is Sole Proprietor?:No
Enumeration Date:2016-08-28
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH000398391835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist