Healthcare Provider Details

I. General information

NPI: 1154324150
Provider Name (Legal Business Name): MARISA LYNN ROWEN PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. MARISA LYNN SOTO

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

839 W CONGRESS ST
TUCSON AZ
85745-2819
US

IV. Provider business mailing address

839 W CONGRESS ST
TUCSON AZ
85745-2819
US

V. Phone/Fax

Practice location:
  • Phone: 520-670-3909
  • Fax: 520-309-2560
Mailing address:
  • Phone: 520-670-3909
  • Fax: 520-309-2560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6207
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number12556
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number12556
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: