Provider Demographics
NPI:1487846671
Name:BERKEY, NAOMI J (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:J
Last Name:BERKEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 AIRPORT WAY SW
Mailing Address - Street 2:
Mailing Address - City:DESERT AIRE
Mailing Address - State:WA
Mailing Address - Zip Code:99349-1973
Mailing Address - Country:US
Mailing Address - Phone:509-366-3733
Mailing Address - Fax:
Practice Address - Street 1:217 AIRPORT WAY SW
Practice Address - Street 2:
Practice Address - City:DESERT AIRE
Practice Address - State:WA
Practice Address - Zip Code:99349-1973
Practice Address - Country:US
Practice Address - Phone:509-366-3733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP5828183500000X
WAPH60474768183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist