Provider Demographics
NPI:1871745505
Name:WEBBENHURST, STEVEN
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:WEBBENHURST
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14612 N LOWE RD
Mailing Address - Street 2:
Mailing Address - City:MEAD
Mailing Address - State:WA
Mailing Address - Zip Code:99021-9431
Mailing Address - Country:US
Mailing Address - Phone:509-466-8673
Mailing Address - Fax:
Practice Address - Street 1:14612 N LOWE RD
Practice Address - Street 2:
Practice Address - City:MEAD
Practice Address - State:WA
Practice Address - Zip Code:99021-9431
Practice Address - Country:US
Practice Address - Phone:509-466-8673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-13
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAWA00016338183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA00016338OtherWA LICENSE NUMBER