Provider Demographics
NPI:1487638383
Name:BREMER, WENDY KAY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:KAY
Last Name:BREMER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 122ND DR SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98205-4511
Mailing Address - Country:US
Mailing Address - Phone:425-335-5501
Mailing Address - Fax:
Practice Address - Street 1:621 SR 9
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-8525
Practice Address - Country:US
Practice Address - Phone:425-334-4028
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist