Healthcare Provider Details

I. General information

NPI: 1902692437
Provider Name (Legal Business Name): HUNTER REED ROTH PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2025
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9040A JACKSON AVE
JOINT BASE LEWIS MCCHORD WA
98431-0001
US

IV. Provider business mailing address

1502 200TH STREET CT E
SPANAWAY WA
98387-8195
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-1110
  • Fax:
Mailing address:
  • Phone: 419-277-5027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03444331
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: