Healthcare Provider Details

I. General information

NPI: 1275598385
Provider Name (Legal Business Name): ERIN NICOLE EDWARDS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1432 N STEELE ST
TACOMA WA
98406-8013
US

IV. Provider business mailing address

1432 N STEELE ST
TACOMA WA
98406-8013
US

V. Phone/Fax

Practice location:
  • Phone: 253-426-6692
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00061388
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: