Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Dominique Marie Patthanachardenphon, PHARMD

Individual provider Pharmacist · NPI 1871618967

Dr. Dominique Marie Patthanachardenphon, PHARMD is a Pharmacist in Grand Rapids, Michigan. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007
What do these letters mean?
PHARMD — Doctor of Pharmacy
The professional degree required to practise as a pharmacist in the United States.

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Practice location Address checks out

665 Seward Ave NW Ste 320
Grand Rapids, MI 49504-5190
Phone: (616) 267-7029
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 051-289748 (IL)

Record details

NPI number1871618967
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHARMD
Sole proprietorNo
NPI enumeratedMarch 20, 2007
Last updated in NPPESJune 14, 2017

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