Provider Demographics
NPI:1942612460
Name:BEHRENS, PAUL (PHARMD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:BEHRENS
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 1:2979 SQUALICUM PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1811
Mailing Address - Country:US
Mailing Address - Phone:360-788-6934
Mailing Address - Fax:360-788-6935
Practice Address - Street 1:2979 SQUALICUM PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1811
Practice Address - Country:US
Practice Address - Phone:360-788-6934
Practice Address - Fax:360-788-6935
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-02
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH604609511835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy