Provider Demographics
NPI:1356494611
Name:CONITZ, CASS CAMERON (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:CASS
Middle Name:CAMERON
Last Name:CONITZ
Suffix:
Gender:M
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 1:1717 S J ST
Mailing Address - Street 2:MS 01-79
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4933
Mailing Address - Country:US
Mailing Address - Phone:253-426-6692
Mailing Address - Fax:253-426-4949
Practice Address - Street 1:1717 S J ST
Practice Address - Street 2:MAIN PHARMACY
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4933
Practice Address - Country:US
Practice Address - Phone:253-426-6692
Practice Address - Fax:253-426-4949
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH000419921835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy