Healthcare Provider Details

I. General information

NPI: 1639156730
Provider Name (Legal Business Name): MRS. CHERYL LOUISE TOIVOLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 06/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22803 44TH AVE W
MOUNTLAKE TERRACE WA
98043-5032
US

IV. Provider business mailing address

22803 44TH AVE W
MOUNTLAKE TERRACE WA
98043-5032
US

V. Phone/Fax

Practice location:
  • Phone: 425-771-3837
  • Fax:
Mailing address:
  • Phone: 425-771-3837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10072
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: