MEDICARE: ERIC MARQUIS

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
1	183500000X	Pharmacist	PH00021965	WA

General Provider Information

NPI Number	:	1285178723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC MARQUIS

Provider Business Mailing Address
First Line	:	1250 SW ERIE ST
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-3103
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1250 SW ERIE ST
Second Line	:
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-3103
Country	:	US
Telephone Number	:	360-279-0671
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2016
Last Update Date	:	12/16/2016

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Directions to “ ERIC MARQUIS ” Practice Location

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