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General NPI Number Information
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NPI Number | 1548987902
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Entity Type | Individual
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Provider Name | COLENE JOYCE ANGKICO
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Gender | Female
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Dates
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Enumeration Date | 10/25/2022
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 14901 4TH AVE SW
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City | BURIEN
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State | WA
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Zip | 98166-1906
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Country | US
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Telephone | 206-242-1202
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Fax |
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Provider Business Mailing Address
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Address Line | 14901 4TH AVE SW
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City | BURIEN
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State | WA
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Zip | 98166-1906
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Country | US
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Telephone |
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | VA61259034
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | VA61259034
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License Number State | WA
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