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NPI Code Detail

MEDICARE: PHILLIP MICHAEL ANCIAUX PHARMD

MEDICARE: PHILLIP MICHAEL ANCIAUX PHARMD
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
1183500000XPharmacistPH 60626956WA
2183500000XPharmacist22253IA
3183500000XPharmacist122151MN

General Provider Information

NPI Number : 1811441850
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILLIP MICHAEL ANCIAUX PHARMD
Provider Business Mailing Address
First Line : 3925 236TH AVE NE
Second Line :
City : REDMOND
State : WA
Zip : 98053-8455
Country : US
Telephone Number : 425-836-9173
Fax Number : 425-836-8728
Provider Business Practice Location Address
First Line : 3925 236TH AVE NE
Second Line :
City : REDMOND
State : WA
Zip : 98053-8455
Country : US
Telephone Number : 425-836-9173
Fax Number : 425-836-8728
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2016
Last Update Date : 01/23/2017

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Directions to “ PHILLIP MICHAEL ANCIAUX PHARMD” Practice Location

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