Provider Demographics
NPI:1437648359
Name:HINES, SARAH BEVAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:BEVAN
Last Name:HINES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:BEVAN
Other - Last Name:HERIFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1230 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-3166
Mailing Address - Country:US
Mailing Address - Phone:360-575-4841
Mailing Address - Fax:360-636-6249
Practice Address - Street 1:1230 7TH AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-3166
Practice Address - Country:US
Practice Address - Phone:360-575-4841
Practice Address - Fax:360-636-6249
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH000221241835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care