Provider Demographics
NPI:1508023672
Name:KUPPLER, WENDY NELCENE (PHARMACY TECH A)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:NELCENE
Last Name:KUPPLER
Suffix:
Gender:F
Credentials:PHARMACY TECH A
Other - Prefix:MISS
Other - First Name:WENDY
Other - Middle Name:NELCENE
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:N/A
Mailing Address - Street 1:20516 54TH AVE W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-7620
Mailing Address - Country:US
Mailing Address - Phone:425-776-3923
Mailing Address - Fax:
Practice Address - Street 1:20516 54TH AVE W
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-7620
Practice Address - Country:US
Practice Address - Phone:425-776-3923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA00041306183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician