Provider Demographics
NPI:1407959885
Name:VANDERHOUWEN, KARI LYNN (RPH)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:LYNN
Last Name:VANDERHOUWEN
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:PO BOX 459
Mailing Address - Street 2:
Mailing Address - City:DUVALL
Mailing Address - State:WA
Mailing Address - Zip Code:98019-0459
Mailing Address - Country:US
Mailing Address - Phone:425-788-2644
Mailing Address - Fax:425-788-2645
Practice Address - Street 1:15602 MAIN STREET NE
Practice Address - Street 2:SUITE 210
Practice Address - City:DUVALL
Practice Address - State:WA
Practice Address - Zip Code:98019
Practice Address - Country:US
Practice Address - Phone:425-788-2644
Practice Address - Fax:425-788-2645
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2012-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00016639183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist