Christina Marie Renzema, PHARM.D, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH60496163 Issued in WA

Practice address

3307 SE Evergreen BLDG 5
Safeway Pharmacy #1687
Washougal, WA 98671

Phone

(360) 335-2006

Fax

(360) 335-2008

NPI assigned

Aug 23, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Ms. Christina Marie Ward Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy, Registered Pharmacist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602460800000",
    "number": "1568862829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3307 SE EVERGREEN BLDG 5",
            "address_2": "SAFEWAY PHARMACY #1687",
            "city": "WASHOUGAL",
            "state": "WA",
            "postal_code": "98671",
            "telephone_number": "360-335-2006",
            "fax_number": "360-335-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3307 SE EVERGREEN BLDG 5",
            "address_2": "SAFEWAY PHARMACY #1687",
            "city": "WASHOUGAL",
            "state": "WA",
            "postal_code": "98671",
            "telephone_number": "360-335-2006",
            "fax_number": "360-335-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENZEMA",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PHARM.D, RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-23",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "PI0010963",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0014373",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60496163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "WARD",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Pharmacist in Washougal, WA
• Providers in Washougal, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.