Provider Demographics
NPI:1437331451
Name:WILLIAMS, ANTHONY LADON (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:LADON
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 SIMMONS ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:DUPONT
Mailing Address - State:WA
Mailing Address - Zip Code:98327-7764
Mailing Address - Country:US
Mailing Address - Phone:253-912-4473
Mailing Address - Fax:
Practice Address - Street 1:2420 SIMMONS ST UNIT A
Practice Address - Street 2:
Practice Address - City:DUPONT
Practice Address - State:WA
Practice Address - Zip Code:98327-7764
Practice Address - Country:US
Practice Address - Phone:253-912-4473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA00066649183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAVA00066649OtherPHARMACY TECHNICIAN LICEN