MEDICARE: NOLA VAUGHAN RASMUSSEN 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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	PH00018065	WA

General Provider Information

NPI Number	:	1568917797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOLA VAUGHAN RASMUSSEN RPH

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 STE 12
Second Line	:
City	:	PUYALLUP
State	:	WA
Zip	:	98371-4488
Country	:	US
Telephone Number	:	253-840-8183
Fax Number	:	253-840-8177

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

Provider Enumeration Date	:	08/17/2016
Last Update Date	:	06/22/2026

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