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NPI Code Detail

MEDICARE: PETER WAY ENG RPH

MEDICARE: PETER WAY ENG RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPH 00015097WA

General Provider Information

NPI Number : 1225303175
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER WAY ENG RPH
Provider Business Mailing Address
First Line : 7411 NE 117TH AVE
Second Line :
City : VANCOUVER
State : WA
Zip : 98662-4706
Country : US
Telephone Number : 360-896-3533
Fax Number : 360-896-3527
Provider Business Practice Location Address
First Line : 7411 NE 117TH AVE
Second Line :
City : VANCOUVER
State : WA
Zip : 98662-4706
Country : US
Telephone Number : 360-896-3533
Fax Number : 360-896-3527
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2012
Last Update Date : 03/11/2012

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