Provider Demographics
NPI:1356641872
Name:AICHELE, KENDALL ALICE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KENDALL
Middle Name:ALICE
Last Name:AICHELE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 NE 289TH ST
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:WA
Mailing Address - Zip Code:98642-9102
Mailing Address - Country:US
Mailing Address - Phone:360-887-0630
Mailing Address - Fax:
Practice Address - Street 1:408 NE 81ST ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8111
Practice Address - Country:US
Practice Address - Phone:360-574-8824
Practice Address - Fax:360-571-2170
Is Sole Proprietor?:No
Enumeration Date:2010-10-31
Last Update Date:2010-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00017329183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist