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General NPI Number Information
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NPI Number | 1922523810
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Entity Type | Individual
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Provider Name | TALAYEH KHOSHAB PHARM. D.
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Gender | Female
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Dates
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Enumeration Date | 08/11/2017
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Last Update Date | 08/11/2017
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Provider Practice Location Address
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Address Line | 1850 S MILDRED ST
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City | TACOMA
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State | WA
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Zip | 98465-1608
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Country | US
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Telephone | 253-460-9599
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Fax |
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Provider Business Mailing Address
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Address Line | 3633 MARKET PL W APT 205
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-4491
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Country | US
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Telephone | 585-290-8454
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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 | 60763875
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License Number State | WA
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