Provider Demographics
NPI:1922293380
Name:BONING, WENDY LEIGH (RPH)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:LEIGH
Last Name:BONING
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2921 11TH ST S
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-0827
Mailing Address - Country:US
Mailing Address - Phone:703-979-1425
Mailing Address - Fax:703-979-1436
Practice Address - Street 1:2921 11TH ST S
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-0827
Practice Address - Country:US
Practice Address - Phone:703-979-1425
Practice Address - Fax:703-979-1436
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204149183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist