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General NPI Number Information
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NPI Number | 1578217931
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Entity Type | Individual
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Provider Name | SHINDY BADANGUIO
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Gender | Female
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Dates
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Enumeration Date | 02/04/2022
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 3023 78TH AVE SE
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City | MERCER ISLAND
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State | WA
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Zip | 98040-2822
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Country | US
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Telephone | 206-236-0776
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Fax | 206-236-2467
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Provider Business Mailing Address
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Address Line | 3023 78TH AVE SE
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City | MERCER ISLAND
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State | WA
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Zip | 98040-2822
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Country | US
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Telephone | 206-236-0776
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Fax | 206-236-2467
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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 | VA60586403
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License Number State | WA
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