Provider Demographics
NPI:1942428503
Name:FRITZ, JAMIE DENISE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:DENISE
Last Name:FRITZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:DENISE
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14807 SE GRAHAM RD
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-8503
Mailing Address - Country:US
Mailing Address - Phone:360-241-8866
Mailing Address - Fax:
Practice Address - Street 1:14807 SE GRAHAM RD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-8503
Practice Address - Country:US
Practice Address - Phone:360-241-8866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00051611183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist