Basic Information
| Provider Information | |||||||||
| NPI: | 1881328805 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAYS | ||||||||
| FirstName: | LAURA | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4402 NE 118TH ST | ||||||||
| Address2: | |||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986865963 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606000542 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4400 NE HALSEY ST BLDG 2 | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972131545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5038936900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2022 | ||||||||
| LastUpdateDate: | 07/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | RPH-0018604 | OR | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.