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General NPI Number Information
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NPI Number | 1386593564
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Entity Type | Individual
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Provider Name | LAVERN GONZALES HERRERA RPH
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Gender | Female
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Dates
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Enumeration Date | 01/22/2026
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 28817 MILITARY RD S
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City | FEDERAL WAY
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State | WA
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Zip | 98003-7912
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Country | US
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Telephone | 253-839-1027
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Fax | 253-839-1651
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Provider Business Mailing Address
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Address Line | 28817 MILITARY RD S
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City | FEDERAL WAY
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State | WA
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Zip | 98003-7912
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Country | US
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Telephone | 253-839-1027
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Fax | 253-839-1651
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH61684077
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License Number State | WA
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