Provider Demographics
NPI:1538120571
Name:THOME, JOEL A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:A
Last Name:THOME
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 E GOODLANDER RD
Mailing Address - Street 2:PMB #8
Mailing Address - City:SELAH
Mailing Address - State:WA
Mailing Address - Zip Code:98942-8847
Mailing Address - Country:US
Mailing Address - Phone:509-697-6125
Mailing Address - Fax:
Practice Address - Street 1:119 E 3RD AVE
Practice Address - Street 2:
Practice Address - City:SELAH
Practice Address - State:WA
Practice Address - Zip Code:98942-1430
Practice Address - Country:US
Practice Address - Phone:509-697-6125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH000607391835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy