Provider Demographics
NPI:1942823232
Name:WOOLARD, CHRISTIE HEATH
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:HEATH
Last Name:WOOLARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SOPHIE TRETTEVICK INDIAN HEALTH CENTER
Mailing Address - Street 2:250 FORT ST
Mailing Address - City:NEAH BAY
Mailing Address - State:WA
Mailing Address - Zip Code:98357
Mailing Address - Country:US
Mailing Address - Phone:360-645-2233
Mailing Address - Fax:
Practice Address - Street 1:SOPHIE TRETTEVICK INDIAN HEALTH CENTER
Practice Address - Street 2:250 FORT ST
Practice Address - City:NEAH BAY
Practice Address - State:WA
Practice Address - Zip Code:98357
Practice Address - Country:US
Practice Address - Phone:360-645-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC17564183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist