Provider Demographics
NPI:1215229828
Name:STANLEY, CHRISTIE D (PHARM D)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:D
Last Name:STANLEY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10201 SE 240TH ST
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-5726
Mailing Address - Country:US
Mailing Address - Phone:253-859-5533
Mailing Address - Fax:253-859-5541
Practice Address - Street 1:10201 SE 240TH ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-5726
Practice Address - Country:US
Practice Address - Phone:253-859-5533
Practice Address - Fax:253-859-5541
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-15
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60148523183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist