Provider Demographics
NPI:1710195730
Name:PFEFFER, GARRY (RPH)
Entity Type:Individual
Prefix:
First Name:GARRY
Middle Name:
Last Name:PFEFFER
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 1:4937 S SWENSON RD
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:WA
Mailing Address - Zip Code:99006-9465
Mailing Address - Country:US
Mailing Address - Phone:509-276-5824
Mailing Address - Fax:
Practice Address - Street 1:4937 S SWENSON RD
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:WA
Practice Address - Zip Code:99006-9465
Practice Address - Country:US
Practice Address - Phone:509-276-5824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00011024183500000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered282N00000XHospitalsGeneral Acute Care Hospital