Provider Demographics
NPI:1356584825
Name:WELLHOUSER, JANET LEE (RPH)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:LEE
Last Name:WELLHOUSER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1136 IHIIHI AVE
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-1228
Mailing Address - Country:US
Mailing Address - Phone:808-744-5106
Mailing Address - Fax:
Practice Address - Street 1:1136 IHIIHI AVE
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-1228
Practice Address - Country:US
Practice Address - Phone:808-744-5106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH 974183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist