Provider Demographics
NPI:1902128523
Name:STOMMES, CREIGHTON JAMES (RPH)
Entity Type:Individual
Prefix:MR
First Name:CREIGHTON
Middle Name:JAMES
Last Name:STOMMES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 COOPER POINT RD SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-5734
Mailing Address - Country:US
Mailing Address - Phone:360-570-8008
Mailing Address - Fax:360-570-9162
Practice Address - Street 1:1510 COOPER POINT RD SW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-5734
Practice Address - Country:US
Practice Address - Phone:360-570-8008
Practice Address - Fax:360-570-9162
Is Sole Proprietor?:No
Enumeration Date:2010-02-23
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA18960183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist