Healthcare Provider Details

I. General information

NPI: 1134106792
Provider Name (Legal Business Name): PAUL FRANKLIN LUCHINO RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2005
Last Update Date: 10/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 6TH AVE
TACOMA WA
98406-5405
US

IV. Provider business mailing address

PO BOX 1212
VAUGHN WA
98394-1212
US

V. Phone/Fax

Practice location:
  • Phone: 253-761-1248
  • Fax: 253-761-7462
Mailing address:
  • Phone: 253-857-0096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00020857
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: