Provider Demographics
NPI:1942500251
Name:PREBLE, KATHRYN GRACE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:GRACE
Last Name:PREBLE
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 1:2710 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-2032
Mailing Address - Country:US
Mailing Address - Phone:509-235-6030
Mailing Address - Fax:509-235-6386
Practice Address - Street 1:2710 1ST ST
Practice Address - Street 2:
Practice Address - City:CHENEY
Practice Address - State:WA
Practice Address - Zip Code:99004-2032
Practice Address - Country:US
Practice Address - Phone:509-235-6030
Practice Address - Fax:509-235-6386
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA10914183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist