MEDICARE: DR. TASHEBA WEST 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
1	183500000X	Pharmacist	PH60029110	WA

General Provider Information

NPI Number	:	1912242660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TASHEBA WEST PHARMD

Provider Business Mailing Address
First Line	:	6901 S 19TH ST
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98466-5529
Country	:	US
Telephone Number	:	253-534-3033
Fax Number	:	253-534-3027

Provider Business Practice Location Address
First Line	:	6901 S 19TH ST
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98466-5529
Country	:	US
Telephone Number	:	253-534-3033
Fax Number	:	253-534-3027

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

Provider Enumeration Date	:	12/06/2012
Last Update Date	:	12/06/2012

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