Provider Demographics
NPI:1871360826
Name:VO, ANNIE (PHARMD)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:
Last Name:VO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3206 NW 47TH DR
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-6855
Mailing Address - Country:US
Mailing Address - Phone:360-448-1672
Mailing Address - Fax:
Practice Address - Street 1:3307 EVERGREEN WAY STE 5
Practice Address - Street 2:
Practice Address - City:WASHOUGAL
Practice Address - State:WA
Practice Address - Zip Code:98671-2063
Practice Address - Country:US
Practice Address - Phone:360-335-2006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61452353183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist