Provider Demographics
NPI:1982772380
Name:IPSEN, DAWN MARIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:IPSEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10827 201ST ST SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-8198
Mailing Address - Country:US
Mailing Address - Phone:360-668-0455
Mailing Address - Fax:360-568-3626
Practice Address - Street 1:700 AVENUE D
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2333
Practice Address - Country:US
Practice Address - Phone:360-568-7787
Practice Address - Fax:360-568-3626
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH39847183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist