MEDICARE: GLORIA D WARNER 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
1	183500000X	Pharmacist	PH00013812	WA

General Provider Information

NPI Number	:	1336270180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLORIA D WARNER RPH

Provider Business Mailing Address
First Line	:	14618 206TH AVE SE
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98059-8914
Country	:	US
Telephone Number	:	425-226-9817
Fax Number	:

Provider Business Practice Location Address
First Line	:	20518 108TH AVE SE
Second Line	:
City	:	KENT
State	:	WA
Zip	:	98031-1542
Country	:	US
Telephone Number	:	253-854-8181
Fax Number	:	253-850-7631

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

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	07/08/2007

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