Provider Demographics
NPI:1851632889
Name:BARNES, IAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:IAN
Middle Name:
Last Name:BARNES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 CARLI CT
Mailing Address - Street 2:
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-9100
Mailing Address - Country:US
Mailing Address - Phone:513-314-1826
Mailing Address - Fax:
Practice Address - Street 1:1890 IRONDALE RD
Practice Address - Street 2:
Practice Address - City:PORT HADLOCK
Practice Address - State:WA
Practice Address - Zip Code:98339-9582
Practice Address - Country:US
Practice Address - Phone:360-385-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60230120183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist