MEDICARE: DORCAS SANTIAGO

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	183700000X	Pharmacy Technician	9110	PR

General Provider Information

NPI Number	:	1306384748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DORCAS SANTIAGO

Provider Business Mailing Address
First Line	:	8605 ZIRCON DR SW UNIT C6
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98498-4003
Country	:	US
Telephone Number	:	787-219-1373
Fax Number	:

Provider Business Practice Location Address
First Line	:	8605 ZIRCON DR SW UNIT C6
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98498-4003
Country	:	US
Telephone Number	:	787-219-1373
Fax Number	:

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

Provider Enumeration Date	:	02/06/2017
Last Update Date	:	02/06/2017

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Directions to “ DORCAS SANTIAGO ” Practice Location

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