Provider Demographics
NPI:1386333722
Name:BARFUSS, CODY DIONYSUS (PHARMD)
Entity type:Individual
Prefix:
First Name:CODY
Middle Name:DIONYSUS
Last Name:BARFUSS
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 1:4619 NE 112TH AVE APT K205
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-5436
Mailing Address - Country:US
Mailing Address - Phone:435-232-7414
Mailing Address - Fax:
Practice Address - Street 1:100 E 33RD ST STE 100
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-2776
Practice Address - Country:US
Practice Address - Phone:360-429-0613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0019012183500000X
WAPH61441586183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist