MEDICARE: MRS. TRENA SIMEK 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	14245	WA

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	:	1538210091
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TRENA SIMEK RPH

Provider Business Mailing Address
First Line	:	PO BOX 5127
Second Line	:
City	:	EVERETT
State	:	WA
Zip	:	98206-5127
Country	:	US
Telephone Number	:	425-317-3619
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 41ST ST
Second Line	:
City	:	EVERETT
State	:	WA
Zip	:	98203-2355
Country	:	US
Telephone Number	:	425-317-3619
Fax Number	:

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

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	12/09/2016

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