Provider Demographics
NPI:1235592155
Name:BUTLER, ALEXANDRIA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRIA
Middle Name:
Last Name:BUTLER
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 1:204 S 3RD ST BLDG 304
Mailing Address - Street 2:PSC 3613
Mailing Address - City:ALTUS AFB
Mailing Address - State:OK
Mailing Address - Zip Code:73523-5129
Mailing Address - Country:US
Mailing Address - Phone:412-606-2739
Mailing Address - Fax:
Practice Address - Street 1:5900 LITTLEROCK RD SW
Practice Address - Street 2:WALMART PHARMACY
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-7355
Practice Address - Country:US
Practice Address - Phone:360-350-6030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60619912183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist