Provider Demographics
NPI:1619207388
Name:DEVRIES, FRANCES MARY (RPH)
Entity Type:Individual
Prefix:MISS
First Name:FRANCES
Middle Name:MARY
Last Name:DEVRIES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98248-9451
Mailing Address - Country:US
Mailing Address - Phone:360-384-7658
Mailing Address - Fax:360-384-7661
Practice Address - Street 1:1901 MAIN ST
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:WA
Practice Address - Zip Code:98248-9451
Practice Address - Country:US
Practice Address - Phone:360-384-7658
Practice Address - Fax:360-384-7661
Is Sole Proprietor?:No
Enumeration Date:2010-01-01
Last Update Date:2010-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00046301183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist