Provider Demographics
NPI:1487920682
Name:WALTERS, CARRIE A (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:A
Last Name:WALTERS
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 1:101 WELLSIAN WAY
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4150
Mailing Address - Country:US
Mailing Address - Phone:509-943-8358
Mailing Address - Fax:509-943-3236
Practice Address - Street 1:101 WELLSIAN WAY
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4150
Practice Address - Country:US
Practice Address - Phone:509-943-8353
Practice Address - Fax:509-943-3236
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00040110183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist