Provider Demographics
NPI:1720040173
Name:BAILEY, ETHEL M (PHARMD)
Entity Type:Individual
Prefix:
First Name:ETHEL
Middle Name:M
Last Name:BAILEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 LACY PL
Mailing Address - Street 2:
Mailing Address - City:E WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-5033
Mailing Address - Country:US
Mailing Address - Phone:509-881-2701
Mailing Address - Fax:509-881-2701
Practice Address - Street 1:1380 N MILLER ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-1544
Practice Address - Country:US
Practice Address - Phone:509-663-7805
Practice Address - Fax:509-664-0548
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00021586183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist