Provider Demographics
NPI:1104635143
Name:EDLER, AUDREY NEWR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:NEWR
Last Name:EDLER
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 1:3788 NE 4TH ST APT H203
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-8486
Mailing Address - Country:US
Mailing Address - Phone:509-559-9520
Mailing Address - Fax:
Practice Address - Street 1:4300 NE 4TH ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98059-5008
Practice Address - Country:US
Practice Address - Phone:425-873-2091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61590857183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist