MEDICARE: WEST OLYMPIA PHARMACY

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	3336C0004X	Compounding Pharmacy
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528441417
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST OLYMPIA PHARMACY

Provider Business Mailing Address
First Line	:	400 YAUGER WAY SW STE B
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-8140
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 YAUGER WAY SW
Second Line	:	STE B
City	:	OLYMPIA
State	:	WA
Zip	:	98502-8139
Country	:	US
Telephone Number	:	360-742-3340
Fax Number	:	360-742-3783

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	HAARIS UDDIN
Credential	:
Telephone Number	:	204-899-8003

Provider Enumeration Date	:	07/09/2015
Last Update Date	:	02/20/2026

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Directions to “WEST OLYMPIA PHARMACY ” Practice Location

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