MRS. BROOKE ALEXIS B HENNINGER (NPI# 1174099139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174099139 |
| Entity Type | Individual |
| Full Name | MRS. BROOKE ALEXIS B HENNINGER |
| Credential | PHARMD |
| Practice Address |
1200 Harrison Ave Centralia WA 98531-1853 |
| Mailing Address |
3135 Vista Verde Ln Sw Tumwater WA 98512-1448 |
| Practice Telephone | 3608072014 |
| Mailing Telephone | 9259808440 |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2018-10-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PH60877507 | WA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346340395 | Brooke Sarah Henninger | Internal Medicine | 1425 Portland Ave # 400, Rochester, NY 14621-3001 | 2006-09-22 |
| Street Address |
1200 HARRISON AVE |
| City | CENTRALIA |
| State | WA |
| Zip Code | 98531-1853 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144744368 | Jean Remy Mutumwa | Pharmacist | 1200 Harrison Ave, Centralia, WA 98531-1853 | 2017-07-29 |
| 1588190458 | Arinze Paul Agbapuru | Pharmacist | 1200 Harrison Ave, Centralia, WA 98531-1853 | 2017-05-11 |
| 1700259694 | Youngsoo Kim | Pharmacist | 1200 Harrison Ave, Centralia, WA 98531-1853 | 2015-11-02 |
| 1023487949 | Hardik Ajudia | Pharmacist | 1200 Harrison Ave, Centralia, WA 98531-1853 | 2015-09-21 |
| 1659770410 | Jeongmin Kim | Pharmacist | 1200 Harrison Ave, Centralia, WA 98531-1853 | 2014-08-18 |
| 1124387030 | James A Matoza | Pharmacist | 1200 Harrison Ave, Centralia, WA 98531-1853 | 2012-05-11 |
| 1053602748 | Janet Eileen Granger | Pharmacist | 1200 Harrison Ave, Centralia, WA 98531-1853 | 2011-04-28 |
| 1578854311 | Onileola Mayowa Ilesanmi | Pharmacist | 1200 Harrison Ave, Centralia, WA 98531-1853 | 2011-04-27 |
| 1134238454 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 1200 Harrison Ave, Centralia, WA 98531-1853 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306462205 | Jelisa Renae Thomas | Counselor | 3510 Steelhammer Ln, Centralia, WA 98531 | 2020-06-17 |
| 1205498607 | Jennifer Kristine Mcglynn Paterno | Counselor | 2428 W. Reynods Ave, Centralia, WA 98531 | 2019-07-05 |
| 1538646328 | Adam Jeffrey Moore | Counselor | 3510 Steelhammer Lane, Centralia, WA 98531 | 2018-07-24 |
| 1144706698 | Euijeong Kim | Occupational Therapist | Rehabilitation Therapies, 914 S. Scheuber Rd, Centralia, WA 98531 | 2018-07-18 |
| 1104315266 | Margaret Fowler Floyd | Registered Nurse | Centralia High School, 813 Eshom Road, Centralia, WA 98531 | 2018-05-04 |
| 1124545777 | Samantha Michelle Moody | Speech-Language Pathologist | Centralia School District, 2320 Borst Ave, Centralia, WA 98531 | 2017-08-24 |
| 1821520289 | Alexa Franks | Behavior Technician | 2428 West Reynolds Ave., Centralia, WA 98531 | 2017-04-03 |
| 1023559861 | Brandy Michelle Peterson | Counselor | 135 W. Main Steet, Centralia, WA 98531 | 2017-03-13 |
| 1841738812 | Graceful Healing Naturopathic | Naturopath | 219 N Tower Ave, Suite 304, Centralia, WA 98531 | 2017-02-09 |
| 1043681513 | Angela Naillon | Counselor | 2428 West Reynolds, Centralia, WA 98531 | 2015-10-09 |
| Find all providers in zip 98531 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255695698 | Douglas Adam Reis | Pharmacist | 1800 Cooks Hill Rd Ste C, Centralia, WA 98531-9162 | 2012-06-29 |
| 1104127406 | Wendy Takwoon Wong | Pharmacist | 1800 Cooks Hill Rd Ste B, Centralia, WA 98531-9162 | 2010-11-03 |
| 1013039460 | William Earl Hayes | Pharmacist | 20311 Old Highway 9 Sw, Centralia, WA 98531-9620 | 2007-04-05 |
| 1407456460 | Lindsey Tucker | Pharmacist | 1212 W Mccord St, Centralia, IL 62801-5648 | 2020-10-29 |
| 1609476902 | Diann H Brammeier | Pharmacist | 1212 W Mccord St, Centralia, IL 62801-5648 | 2020-10-27 |
| 1275133589 | Lindsay J. Garrison | Pharmacist | 1212 W Mccord St, Centralia, IL 62801-5648 | 2020-10-27 |
| 1346851995 | Katelyn Starr | Pharmacist | 225 N Elm St, Centralia, IL 62801-3248 | 2020-08-16 |
| 1558912733 | Jordan Thomas Nelson | Pharmacist | 1129 Harrison Ave, Centralia, WA 98531-1852 | 2019-09-27 |
| 1871079517 | Laura Knuf | Pharmacist | 1129 W Broadway, Centralia, IL 62801-5353 | 2018-07-16 |
| 1497245575 | Kristen Ann Mahler | Pharmacist | 914 S Scheuber Rd, Centralia, WA 98531-9027 | 2018-05-15 |
| Find all providers in CENTRALIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.