MEDICARE: DONALD L PEARSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PH00011022	WA

General Provider Information

NPI Number	:	1063277432
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD L PEARSON

Provider Business Mailing Address
First Line	:	5115 57TH AVENUE CT W
Second Line	:
City	:	UNIVERSITY PLACE
State	:	WA
Zip	:	98467-4804
Country	:	US
Telephone Number	:	253-820-2290
Fax Number	:

Provider Business Practice Location Address
First Line	:	22623 68TH AVE S
Second Line	:
City	:	KENT
State	:	WA
Zip	:	98032-1981
Country	:	US
Telephone Number	:	253-304-6365
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2024
Last Update Date	:	02/15/2024

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Directions to “ DONALD L PEARSON ” Practice Location

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