Provider Demographics
NPI:1699054379
Name:COOTZ, ORIE (PHARMACIST)
Entity type:Individual
Prefix:MS
First Name:ORIE
Middle Name:
Last Name:COOTZ
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 S.E. MOUNTAIN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:99324
Mailing Address - Country:US
Mailing Address - Phone:509-529-7165
Mailing Address - Fax:
Practice Address - Street 1:317 SE MOUNTAIN VIEW DR
Practice Address - Street 2:
Practice Address - City:COLLEGE PLACE
Practice Address - State:WA
Practice Address - Zip Code:99324-1731
Practice Address - Country:US
Practice Address - Phone:509-529-7165
Practice Address - Fax:509-529-7165
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00021698183500000X
VTPH00021698183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist