Provider Demographics
NPI:1437120607
Name:KRONICK, JUDITH ANN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:ANN
Last Name:KRONICK
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 1:611 31ST AVE SW
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-3723
Mailing Address - Country:US
Mailing Address - Phone:253-445-7162
Mailing Address - Fax:253-445-7163
Practice Address - Street 1:611 31ST AVE SW
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-3723
Practice Address - Country:US
Practice Address - Phone:253-445-7162
Practice Address - Fax:253-445-7163
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00011001183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist