Provider Demographics
NPI:1831463553
Name:ADAMS, LORI ANN
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14202 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:MEAD
Mailing Address - State:WA
Mailing Address - Zip Code:99021-9524
Mailing Address - Country:US
Mailing Address - Phone:509-242-0201
Mailing Address - Fax:
Practice Address - Street 1:215 N COLVILLE RD
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:WA
Practice Address - Zip Code:99006-5015
Practice Address - Country:US
Practice Address - Phone:509-276-9016
Practice Address - Fax:509-276-8890
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA00045622183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician