Provider Demographics
NPI:1649516436
Name:HARBISON, ANDREW JAMES (PHARMD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:JAMES
Last Name:HARBISON
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 1:7080 KILLEEN PL SW
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367-7617
Mailing Address - Country:US
Mailing Address - Phone:509-998-9883
Mailing Address - Fax:
Practice Address - Street 1:7080 KILLEEN PL SW
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98367-7617
Practice Address - Country:US
Practice Address - Phone:509-998-9883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-24
Last Update Date:2012-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH601458361835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy