Provider Demographics
NPI:1396046645
Name:DECHENNE, DONALD JAMES (RPH)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:JAMES
Last Name:DECHENNE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:WA
Mailing Address - Zip Code:99156-9030
Mailing Address - Country:US
Mailing Address - Phone:509-447-3972
Mailing Address - Fax:509-447-1104
Practice Address - Street 1:121 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:WA
Practice Address - Zip Code:99156-9030
Practice Address - Country:US
Practice Address - Phone:509-447-3972
Practice Address - Fax:509-447-1104
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00009223183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist