Provider Demographics
NPI:1790180271
Name:HAMILTON BUCHHOLTZ, RENAE CHRISTINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RENAE
Middle Name:CHRISTINE
Last Name:HAMILTON BUCHHOLTZ
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 1:3650 Q ST
Mailing Address - Street 2:
Mailing Address - City:WASHOUGAL
Mailing Address - State:WA
Mailing Address - Zip Code:98671-9056
Mailing Address - Country:US
Mailing Address - Phone:360-241-4036
Mailing Address - Fax:
Practice Address - Street 1:3650 Q ST
Practice Address - Street 2:
Practice Address - City:WASHOUGAL
Practice Address - State:WA
Practice Address - Zip Code:98671-9056
Practice Address - Country:US
Practice Address - Phone:360-241-4036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 60214924183500000X
ORRPH-0014102183500000X
MT7734183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist