Healthcare Provider Details

I. General information

NPI: 1710130877
Provider Name (Legal Business Name): ANDREA LOUISE EBERLY PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2008
Last Update Date: 10/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 COLBY AVE INPATIENT PHARMACY
EVERETT WA
98201-1665
US

IV. Provider business mailing address

1321 COLBY AVE INPATIENT PHARMACY
EVERETT WA
98201-1665
US

V. Phone/Fax

Practice location:
  • Phone: 425-261-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60015281
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: