Provider Demographics
NPI:1205863446
Name:KLAUS, LYNNETTE RAE (PHARM D)
Entity Type:Individual
Prefix:
First Name:LYNNETTE
Middle Name:RAE
Last Name:KLAUS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8804 NE 339TH ST
Mailing Address - Street 2:
Mailing Address - City:LA CENTER
Mailing Address - State:WA
Mailing Address - Zip Code:98629
Mailing Address - Country:US
Mailing Address - Phone:360-263-6856
Mailing Address - Fax:
Practice Address - Street 1:1603 E FOURTH PLAIN BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3753
Practice Address - Country:US
Practice Address - Phone:360-696-4061
Practice Address - Fax:360-737-1443
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR94181835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy