Provider Demographics
NPI:1629337605
Name:MCCARTY, JANINE MARIE (RPH)
Entity Type:Individual
Prefix:
First Name:JANINE
Middle Name:MARIE
Last Name:MCCARTY
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 1:11325 SE MILL PLAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-5070
Mailing Address - Country:US
Mailing Address - Phone:360-253-7086
Mailing Address - Fax:360-253-7083
Practice Address - Street 1:11325 SE MILL PLAIN BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-5070
Practice Address - Country:US
Practice Address - Phone:360-253-7086
Practice Address - Fax:360-253-7083
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00046812183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist