Provider Demographics
NPI:1508858143
Name:STOREY, DAVID E (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:STOREY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10730 SNAKE RIVER RD
Mailing Address - Street 2:
Mailing Address - City:ASOTIN
Mailing Address - State:WA
Mailing Address - Zip Code:99402-9541
Mailing Address - Country:US
Mailing Address - Phone:509-243-9470
Mailing Address - Fax:
Practice Address - Street 1:1221 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-2829
Practice Address - Country:US
Practice Address - Phone:509-758-5511
Practice Address - Fax:509-758-0119
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00016035183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy