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General NPI Number Information
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NPI Number | 1588729537
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Entity Type | Individual
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Provider Name | VICTORIA L.P. ELIJAH PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1102 S I ST
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City | TACOMA
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State | WA
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Zip | 98405-4559
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Country | US
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Telephone | 253-284-2324
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Fax | 253-284-4131
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Provider Business Mailing Address
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Address Line | PO BOX 23672 2640 SW 347TH ST.
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City | FEDERAL WAY
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State | WA
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Zip | 98093-0672
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Country | US
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Telephone | 253-952-8108
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH00041498
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License Number State | WA
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