Healthcare Provider Details

I. General information

NPI: 1366582595
Provider Name (Legal Business Name): ANGELICA MERCEDES PAULEY PHARMD.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELICA MERCEDES PAULEY PHARMD.

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 12/24/2024
Certification Date: 12/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OCEAN SHORES PHARMACY 121 E. CHANCE-A-LA-MER
OCEAN SHORES WA
98569
US

IV. Provider business mailing address

8315 NORMANDY ST SE UNIT 63
EAST OLYMPIA WA
98540-1002
US

V. Phone/Fax

Practice location:
  • Phone: 360-289-4647
  • Fax: 360-289-3812
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00065779
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH65779
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH65779
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: