Provider Demographics
NPI:1821328139
Name:COLLINS, AYLA (PHARMD)
Entity Type:Individual
Prefix:
First Name:AYLA
Middle Name:
Last Name:COLLINS
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 1:1200 N 14TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-4192
Mailing Address - Country:US
Mailing Address - Phone:509-547-1220
Mailing Address - Fax:509-547-8954
Practice Address - Street 1:1200 N 14TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-4192
Practice Address - Country:US
Practice Address - Phone:509-547-1220
Practice Address - Fax:509-547-8954
Is Sole Proprietor?:No
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60101456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist