Provider Demographics
NPI:1417241795
Name:SEVIGNY, BRIANA (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:SEVIGNY
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 1:665 SLEATER KINNEY RD SE
Mailing Address - Street 2:T-1355
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-1007
Mailing Address - Country:US
Mailing Address - Phone:360-486-8927
Mailing Address - Fax:360-350-6524
Practice Address - Street 1:665 SLEATER KINNEY RD SE
Practice Address - Street 2:T-1355
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1007
Practice Address - Country:US
Practice Address - Phone:360-486-8927
Practice Address - Fax:360-350-6524
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-04
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60090087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist