Provider Demographics
NPI:1407009608
Name:IVIE, BRITTANY NICOLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:NICOLE
Last Name:IVIE
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 1:3850 KLAHANIE DR. SE
Mailing Address - Street 2:APT 20-102
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98029
Mailing Address - Country:US
Mailing Address - Phone:706-461-2312
Mailing Address - Fax:
Practice Address - Street 1:120 106TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-5910
Practice Address - Country:US
Practice Address - Phone:425-454-6513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60015252183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist