Provider Demographics
NPI:1336113976
Name:RITTENHOUSE, DENNIS GLEN (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:GLEN
Last Name:RITTENHOUSE
Suffix:
Gender:M
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12610 135TH ST E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98374-4668
Mailing Address - Country:US
Mailing Address - Phone:253-435-1670
Mailing Address - Fax:
Practice Address - Street 1:2700 BRIDGEPORT WAY W
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4600
Practice Address - Country:US
Practice Address - Phone:253-460-1879
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA00041460247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAVA00041460OtherPHARMACY TECHNICIAN LIC