Provider Demographics
NPI:1205172053
Name:IRION, GRETCHEN DENIKE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:GRETCHEN
Middle Name:DENIKE
Last Name:IRION
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:GRETCHEN
Other - Middle Name:ANNE
Other - Last Name:DENIKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:170 ALAMEDA DE LAS PULGAS
Mailing Address - Street 2:PHARMACY DEPARTMENT
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-2751
Mailing Address - Country:US
Mailing Address - Phone:650-367-5534
Mailing Address - Fax:
Practice Address - Street 1:170 ALAMEDA DE LAS PULGAS
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-2751
Practice Address - Country:US
Practice Address - Phone:650-367-5534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 49535183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist