Healthcare Provider Details

I. General information

NPI: 1730384918
Provider Name (Legal Business Name): PAUL MCCARTY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 02/19/2020
Certification Date: 02/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7131 MARTIN WAY E
OLYMPIA WA
98516-5535
US

IV. Provider business mailing address

3326 MADRONA BEACH RD NW
OLYMPIA WA
98502-8868
US

V. Phone/Fax

Practice location:
  • Phone: 360-493-8614
  • Fax: 360-493-8612
Mailing address:
  • Phone: 360-451-3359
  • Fax: 360-493-8612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License NumberPH00069734
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: