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NPI Code Detail

MEDICARE: MR. VITHYA PHAL

MEDICARE: MR. VITHYA PHAL
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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist16532WA

General Provider Information

NPI Number : 1477792687
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. VITHYA PHAL
Provider Business Mailing Address
First Line : 1100 N MERIDIAN
Second Line :
City : PUYALLUP
State : WA
Zip : 98371-4403
Country : US
Telephone Number : 253-840-8183
Fax Number : 253-840-8177
Provider Business Practice Location Address
First Line : 1100 N MERIDIAN
Second Line :
City : PUYALLUP
State : WA
Zip : 98371-4403
Country : US
Telephone Number : 253-840-8183
Fax Number : 253-840-8177
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2009
Last Update Date : 06/27/2026

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Directions to “ MR. VITHYA PHAL ” Practice Location

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