Provider Demographics
NPI:1699021782
Name:THURSTON, SEAN DYCE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:DYCE
Last Name:THURSTON
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 1:176 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:WA
Mailing Address - Zip Code:99328-1351
Mailing Address - Country:US
Mailing Address - Phone:509-382-2536
Mailing Address - Fax:
Practice Address - Street 1:176 E MAIN ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:WA
Practice Address - Zip Code:99328-1351
Practice Address - Country:US
Practice Address - Phone:509-382-2536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60140196183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist