Provider Demographics
NPI:1275133621
Name:KASHIWSKY, AMANDA D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:D
Last Name:KASHIWSKY
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:PO BOX 343
Mailing Address - Street 2:
Mailing Address - City:GRAND RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44045-0343
Mailing Address - Country:US
Mailing Address - Phone:724-813-1758
Mailing Address - Fax:
Practice Address - Street 1:33752 VINE ST
Practice Address - Street 2:
Practice Address - City:EASTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44095
Practice Address - Country:US
Practice Address - Phone:440-269-8828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03335139183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist