Provider Demographics
NPI:1497447650
Name:SCHOENSTRA, KATHERINE ANN (CPHT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANN
Last Name:SCHOENSTRA
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6421 W VICTORIA AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7605
Mailing Address - Country:US
Mailing Address - Phone:509-222-8769
Mailing Address - Fax:
Practice Address - Street 1:1350 N GRANT ST STE A
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1355
Practice Address - Country:US
Practice Address - Phone:509-400-4600
Practice Address - Fax:509-213-2813
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA60507912183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician