Provider Demographics
NPI:1356615900
Name:WILLIAMS, HOLLIE KRISTIN (RPH)
Entity type:Individual
Prefix:
First Name:HOLLIE
Middle Name:KRISTIN
Last Name:WILLIAMS
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 1:401 NW 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-9105
Mailing Address - Country:US
Mailing Address - Phone:360-666-5133
Mailing Address - Fax:360-666-5127
Practice Address - Street 1:401 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-9105
Practice Address - Country:US
Practice Address - Phone:360-666-5133
Practice Address - Fax:360-666-5127
Is Sole Proprietor?:No
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00017588183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist