Provider Demographics
NPI:1477864627
Name:AUSMEIER, JUSTIN D (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:D
Last Name:AUSMEIER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9430 NE DAY RD
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-3302
Mailing Address - Country:US
Mailing Address - Phone:206-842-4065
Mailing Address - Fax:206-780-2781
Practice Address - Street 1:301 HIGH SCHOOL RD NE
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-1608
Practice Address - Country:US
Practice Address - Phone:206-842-4065
Practice Address - Fax:206-780-2781
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 60105943183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist