Provider Demographics
NPI:1891070850
Name:MELCHER, RICK KENNETH (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICK
Middle Name:KENNETH
Last Name:MELCHER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:RICHARD
Other - Middle Name:KENNETH
Other - Last Name:MELCHER
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:4507 KIMBERLY PLACE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908
Mailing Address - Country:US
Mailing Address - Phone:509-248-3310
Mailing Address - Fax:
Practice Address - Street 1:2310 LONGFIBRE ROAD
Practice Address - Street 2:
Practice Address - City:UNION GAP
Practice Address - State:WA
Practice Address - Zip Code:98903
Practice Address - Country:US
Practice Address - Phone:509-454-4249
Practice Address - Fax:509-454-5426
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPL00011391183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist