Provider Demographics
NPI:1609347954
Name:WALEN, ASHLEY ELIZABETH (PHARMD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ELIZABETH
Last Name:WALEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:ELIZABETH
Other - Last Name:SOBOLIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2801 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-2757
Mailing Address - Country:US
Mailing Address - Phone:319-545-6412
Mailing Address - Fax:
Practice Address - Street 1:2801 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2757
Practice Address - Country:US
Practice Address - Phone:319-545-6412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN124059183500000X
IA23567183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist