Provider Demographics
NPI:1962785030
Name:KLEVEN, BRYAN KEITH (RPH)
Entity type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:KEITH
Last Name:KLEVEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2702 N ARGONNE RD
Mailing Address - Street 2:
Mailing Address - City:MILLWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:99212-2305
Mailing Address - Country:US
Mailing Address - Phone:509-892-1637
Mailing Address - Fax:509-892-3726
Practice Address - Street 1:2702 N ARGONNE RD
Practice Address - Street 2:
Practice Address - City:MILLWOOD
Practice Address - State:WA
Practice Address - Zip Code:99212-2305
Practice Address - Country:US
Practice Address - Phone:509-892-1637
Practice Address - Fax:509-892-3726
Is Sole Proprietor?:No
Enumeration Date:2011-09-24
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00059479183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist