1568645489 NPI number — MRS. CAMILLA RENEE ALBRECHT RPH

Table of content: EAPEN K JACOB M.D. (NPI 1497731731)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568645489 NPI number — MRS. CAMILLA RENEE ALBRECHT RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALBRECHT
Provider First Name:
CAMILLA
Provider Middle Name:
RENEE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568645489
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/22/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14406 NE 20TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VANCOUVER
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98686-1448
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-261-7966
Provider Business Mailing Address Fax Number:
503-261-7977

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14406 NE 20TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98686-1448
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-261-7966
Provider Business Practice Location Address Fax Number:
503-261-7977
Provider Enumeration Date:
12/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835P0018X , with the licence number:  RPH-0009093 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 183500000X , with the licence number: PH00040096 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: PH00040096 . This is a "PHARMACY LISCENSE NUMBER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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