Provider Demographics
NPI:1306111661
Name:HILLMAN, RENAY DAWN (PHARMD)
Entity type:Individual
Prefix:
First Name:RENAY
Middle Name:DAWN
Last Name:HILLMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:RAY
Other - Middle Name:DAWN
Other - Last Name:HILLMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:920 SW PANORAMA DR
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-5968
Mailing Address - Country:US
Mailing Address - Phone:509-432-4426
Mailing Address - Fax:
Practice Address - Street 1:835 SE BISHOP BLVD
Practice Address - Street 2:
Practice Address - City:PULLMAN
Practice Address - State:WA
Practice Address - Zip Code:99163-5512
Practice Address - Country:US
Practice Address - Phone:509-432-4426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-19
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00072327183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist