MEDICARE: ANAND N GOWDA 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	PH00069635	WA

General Provider Information

NPI Number	:	1700038973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANAND N GOWDA RPH

Provider Business Mailing Address
First Line	:	6417 83RD AVE W
Second Line	:
City	:	UNIVERSITY PLACE
State	:	WA
Zip	:	98467-3902
Country	:	US
Telephone Number	:	425-247-4108
Fax Number	:

Provider Business Practice Location Address
First Line	:	3840 BRIDGEPORT WAY W
Second Line	:
City	:	UNIVERSITY PLACE
State	:	WA
Zip	:	98466-4416
Country	:	US
Telephone Number	:	253-460-2875
Fax Number	:	253-460-2985

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

Provider Enumeration Date	:	10/18/2008
Last Update Date	:	05/12/2017

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