Provider Demographics
NPI:1639418148
Name:KLEMMER, DENNIS W (RPH)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:W
Last Name:KLEMMER
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 1:3900 SW 321ST ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-2412
Mailing Address - Country:US
Mailing Address - Phone:253-709-8779
Mailing Address - Fax:
Practice Address - Street 1:3900 SW 321ST ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-2412
Practice Address - Country:US
Practice Address - Phone:253-709-8779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 00016337183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist