Healthcare Provider Details

I. General information

NPI: 1588993968
Provider Name (Legal Business Name): WENDY ROBIN CRUZ PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2009
Last Update Date: 12/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9040 REID ST
TACOMA WA
98431-1100
US

IV. Provider business mailing address

7811 31ST STREET CT NW
GIG HARBOR WA
98335-6065
US

V. Phone/Fax

Practice location:
  • Phone: 253-968-2252
  • Fax:
Mailing address:
  • Phone: 281-413-7515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number38581
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: