Provider Demographics
NPI:1427187491
Name:LOTTIMER, SUSAN ELAINE JONES (PHARMD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:ELAINE JONES
Last Name:LOTTIMER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:ELAINE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2979 SQUALICUM PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1813
Mailing Address - Country:US
Mailing Address - Phone:360-788-6934
Mailing Address - Fax:360-788-6935
Practice Address - Street 1:2979 SQUALICUM PKWY STE 101
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1813
Practice Address - Country:US
Practice Address - Phone:360-788-6934
Practice Address - Fax:360-788-6935
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36256183500000X
WAPH00049669183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist