Provider Demographics
NPI:1952436842
Name:HADLEY, TIMOTHY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:
Last Name:HADLEY
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 1:1649 PLAZA WAY
Mailing Address - Street 2:PHARMACY
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:PHARMACY
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?:No
Enumeration Date:2007-02-22
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA65367183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist