Provider Demographics
NPI:1245537018
Name:SEBASTIAN, DANIELLE LYNN (PHARMD)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LYNN
Last Name:SEBASTIAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3243 CUMMINS WAY
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-3224
Mailing Address - Country:US
Mailing Address - Phone:406-241-6915
Mailing Address - Fax:
Practice Address - Street 1:500 WEST BROADWAY
Practice Address - Street 2:SAINT PATRICK HOSPITAL PHARMACY
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802
Practice Address - Country:US
Practice Address - Phone:406-329-2767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT4440183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist