Provider Demographics
NPI:1790058139
Name:VARADY, ANNA MARIE HARRIS (RPH)
Entity type:Individual
Prefix:
First Name:ANNA MARIE
Middle Name:HARRIS
Last Name:VARADY
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 1:1649 PLAZA WAY
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-4324
Mailing Address - Country:US
Mailing Address - Phone:509-529-9350
Mailing Address - Fax:509-522-0713
Practice Address - Street 1:1649 PLAZA WAY
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-4324
Practice Address - Country:US
Practice Address - Phone:509-529-9350
Practice Address - Fax:509-522-0713
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 00011495183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPH 00011495OtherSTATE PHARMACIST LICENSE