Healthcare Provider Details

I. General information

NPI: 1225399454
Provider Name (Legal Business Name): ALINA DRUTA RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2012
Last Update Date: 06/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 E NORTH BEND WAY
NORTH BEND WA
98045-8270
US

IV. Provider business mailing address

460 E NORTH BEND WAY
NORTH BEND WA
98045-8270
US

V. Phone/Fax

Practice location:
  • Phone: 425-888-2357
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00041507
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: