Healthcare Provider Details

I. General information

NPI: 1669404026
Provider Name (Legal Business Name): LISA RENEE ALLEN B.S., PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1717 S J ST ST. JOSEPH MEDICAL CENTER PHARMACY
TACOMA WA
98405-4933
US

IV. Provider business mailing address

1861 HILLSIDE DR NE
TACOMA WA
98422-4235
US

V. Phone/Fax

Practice location:
  • Phone: 253-426-6692
  • Fax: 253-426-4949
Mailing address:
  • Phone: 253-952-3144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPH00010974
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: