Provider Demographics
NPI:1265754642
Name:DAWSON, BRANDON EDWARD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:EDWARD
Last Name:DAWSON
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 1:1615 DELAWARE ST
Mailing Address - Street 2:ATTN: PHARMACY
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-2367
Mailing Address - Country:US
Mailing Address - Phone:360-414-2000
Mailing Address - Fax:360-414-7366
Practice Address - Street 1:1615 DELAWARE ST
Practice Address - Street 2:ATTN: PHARMACY
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2367
Practice Address - Country:US
Practice Address - Phone:360-414-2000
Practice Address - Fax:360-414-7366
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00070716183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist