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General NPI Number Information
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NPI Number | 1700107737
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Entity Type | Individual
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Provider Name | IVAN VON MESSER PHARM.D
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Gender | Male
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Dates
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Enumeration Date | 06/14/2010
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Last Update Date | 06/14/2010
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Provider Practice Location Address
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Address Line | 5700 100TH STREET SW STE 100 RIGHT AID COMPANY
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City | LAKEWOOD
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State | WA
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Zip | 98499
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Country | US
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Telephone | 253-588-3666
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Fax |
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Provider Business Mailing Address
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Address Line | 2802 N NARROWS DR UNIT C11
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City | TACOMA
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State | WA
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Zip | 98407-1451
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Country | US
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Telephone | 253-495-7543
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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 | PH00070289
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License Number State | WA
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