Healthcare Provider Details

I. General information

NPI: 1922080233
Provider Name (Legal Business Name): I V PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5515 STEILACOOM BLVD SW SUITE 121
TACOMA WA
98499-3105
US

IV. Provider business mailing address

PO BOX 64154
TACOMA WA
98464-0154
US

V. Phone/Fax

Practice location:
  • Phone: 253-581-7660
  • Fax: 253-565-2967
Mailing address:
  • Phone: 253-581-7660
  • Fax: 253-565-2967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPF00002516
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License NumberPF00002516
License Number StateWA

VIII. Authorized Official

Name: DR. HEE-WON PATTEN
Title or Position: PHARMACIST
Credential: PHARMD
Phone: 253-581-7660