Basic Information
| Provider Information | |||||||||
| NPI: | 1316160310 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOOSER | ||||||||
| FirstName: | JANICE | ||||||||
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| Credential: | R.P.H | ||||||||
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| Mailing Information | |||||||||
| Address1: | 955 POWELL AVE SW | ||||||||
| Address2: | SUITE A | ||||||||
| City: | RENTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980552908 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 126 AUBURN AVE | ||||||||
| Address2: | SUITE 104 | ||||||||
| City: | AUBURN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980025057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538043591 | ||||||||
| FaxNumber: | 2538043593 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | PH0001044 | WA | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.