Provider Demographics
NPI:1467752733
Name:KRAUSE, BRITTA
Entity Type:Individual
Prefix:
First Name:BRITTA
Middle Name:
Last Name:KRAUSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E ROSE ST
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-1216
Mailing Address - Country:US
Mailing Address - Phone:509-522-0227
Mailing Address - Fax:509-522-0327
Practice Address - Street 1:215 E ROSE ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-1216
Practice Address - Country:US
Practice Address - Phone:509-522-0227
Practice Address - Fax:509-522-0327
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60167454183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist