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General NPI Number Information
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NPI Number | 1447351572
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Entity Type | Individual
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Provider Name | LOUIS EMIL WOLFROM R.PH
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Gender | Male
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9600 VETERANS DR SW
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City | TACOMA
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State | WA
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Zip | 98493-0003
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Country | US
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Telephone | 253-582-8440
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Fax |
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Provider Business Mailing Address
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Address Line | 5102 27TH ST E
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City | FIFE
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State | WA
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Zip | 98424-2153
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Country | US
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Telephone | 253-922-7308
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Fax |
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | PH00013823
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License Number State | WA
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