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NPI Code Detail

MEDICARE: ELIZABETH MILES RPH

MEDICARE: ELIZABETH MILES 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
1183500000XPharmacistPH00019211WA

General Provider Information

NPI Number : 1336199934
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH MILES RPH
Provider Business Mailing Address
First Line : 24639 156TH AVE SE
Second Line :
City : KENT
State : WA
Zip : 98042-4143
Country : US
Telephone Number : 253-639-0123
Fax Number :
Provider Business Practice Location Address
First Line : 17254 140TH AVE SE
Second Line :
City : RENTON
State : WA
Zip : 98058-7014
Country : US
Telephone Number : 425-226-7000
Fax Number : 425-235-8796
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 07/08/2007

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