Provider Demographics
NPI:1427459635
Name:SANDERS, CHARMAINE YEVETTE (RPH)
Entity type:Individual
Prefix:MS
First Name:CHARMAINE
Middle Name:YEVETTE
Last Name:SANDERS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 COOPER POINT RD NW
Mailing Address - Street 2:STORE #05278 RITE AID
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-4436
Mailing Address - Country:US
Mailing Address - Phone:360-754-8014
Mailing Address - Fax:360-754-0778
Practice Address - Street 1:305 COOPER POINT RD NW
Practice Address - Street 2:STORE #05278 RITE AID
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-4436
Practice Address - Country:US
Practice Address - Phone:360-754-8014
Practice Address - Fax:360-754-0778
Is Sole Proprietor?:No
Enumeration Date:2014-09-07
Last Update Date:2014-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPHARM-PH60329293183500000X
MSE-08017183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist