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NPI Code Detail

MEDICARE: DR. SOPHIA NDEANASIA MAEDA PHARMD

MEDICARE: DR. SOPHIA NDEANASIA MAEDA 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
1183500000XPharmacistRPH-0013591OR
2183500000XPharmacistPH60501862WA

General Provider Information

NPI Number : 1952742082
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SOPHIA NDEANASIA MAEDA PHARMD
Provider Business Mailing Address
First Line : PO BOX 190
Second Line :
City : TOPPENISH
State : WA
Zip : 98948-0190
Country : US
Telephone Number : 508-865-2395
Fax Number : 509-865-7057
Provider Business Practice Location Address
First Line : 2275 COMMERCIAL ST
Second Line :
City : ASTORIA
State : OR
Zip : 97103-3327
Country : US
Telephone Number : 503-338-4175
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2013
Last Update Date : 03/11/2026

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