Provider Demographics
NPI:1467761676
Name:MCCOWAN, CHRISTOPHER RICHARD (PHARM D)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:RICHARD
Last Name:MCCOWAN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 67
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:WA
Mailing Address - Zip Code:99122-0067
Mailing Address - Country:US
Mailing Address - Phone:509-725-1151
Mailing Address - Fax:509-725-3028
Practice Address - Street 1:525 MORGAN ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:WA
Practice Address - Zip Code:99122-0067
Practice Address - Country:US
Practice Address - Phone:509-725-1151
Practice Address - Fax:509-725-3028
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-05
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00070021183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist