Healthcare Provider Details

I. General information

NPI: 1790297232
Provider Name (Legal Business Name): RACHA ALDUGHLI PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2017
Last Update Date: 10/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 S UNION AVE STE 7009
TACOMA WA
98405-1702
US

IV. Provider business mailing address

1901 S UNION AVE STE 7009
TACOMA WA
98405-1702
US

V. Phone/Fax

Practice location:
  • Phone: 253-459-6736
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPH60749693
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: