Provider Demographics
NPI:1730514480
Name:CHAPMAN, BRIAN JOSEPH (PHARMACIST)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:JOSEPH
Last Name:CHAPMAN
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:BRIAN
Other - Middle Name:JOSEPH
Other - Last Name:MAKSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:1100 S MARKET BLVD
Mailing Address - Street 2:ATTN: PHARMACY DEPARTMENT
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-3428
Mailing Address - Country:US
Mailing Address - Phone:360-740-6750
Mailing Address - Fax:
Practice Address - Street 1:1100 S MARKET BLVD
Practice Address - Street 2:ATTN: PHARMACY DEPARTMENT
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-3428
Practice Address - Country:US
Practice Address - Phone:360-740-6750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2013-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00046474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist