Provider Demographics
NPI:1649571274
Name:RICHTER, JOHN PAUL (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:PAUL
Last Name:RICHTER
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 1:2116 SE 131ST AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-6516
Mailing Address - Country:US
Mailing Address - Phone:360-604-5996
Mailing Address - Fax:
Practice Address - Street 1:2116 SE 131ST AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-6516
Practice Address - Country:US
Practice Address - Phone:360-604-5996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-12
Last Update Date:2017-09-05
Deactivation Date:2015-09-02
Deactivation Code:
Reactivation Date:2017-09-05
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0008771183500000X
WAPH60009617183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist