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General NPI Number Information
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NPI Number | 1962455949
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Entity Type | Individual
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Provider Name | STEPHANIE ANN MOJICA RPH
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Gender | Female
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12303 NE 130TH LN SUITE 210
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City | KIRKLAND
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State | WA
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Zip | 98034-3099
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Country | US
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Telephone | 425-899-2790
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Fax | 425-899-2795
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Provider Business Mailing Address
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Address Line | 22921 165TH AVE SE
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City | MONROE
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State | WA
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Zip | 98272-8850
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Country | US
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Telephone | 360-794-6673
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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 | PH00010805
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License Number State | WA
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