Provider Demographics
NPI:1780930982
Name:BETTINESKI, MOLLY MCKAY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:MCKAY
Last Name:BETTINESKI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:501 SE 172ND AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-9542
Mailing Address - Country:US
Mailing Address - Phone:360-397-3602
Mailing Address - Fax:360-604-1791
Practice Address - Street 1:501 SE 172ND AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-9542
Practice Address - Country:US
Practice Address - Phone:360-397-3602
Practice Address - Fax:360-604-1791
Is Sole Proprietor?:No
Enumeration Date:2012-07-25
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00022504183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist