Healthcare Provider Details

I. General information

NPI: 1760974315
Provider Name (Legal Business Name): RACHNA BURMAN PATEL I PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2018
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1708 YAKIMA AVE STE 20
TACOMA WA
98405-5307
US

IV. Provider business mailing address

5314 54TH ST W
UNIVERSITY PLACE WA
98467-3621
US

V. Phone/Fax

Practice location:
  • Phone: 253-426-4727
  • Fax:
Mailing address:
  • Phone: 646-734-6056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number60767146
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: