Keith Acab, PHARM.D.
Individual provider Active NPI Pharmacist · Tacoma, WA
NPI 1104228600 · NPPES record last updated Sep 17, 2014
Key facts
- NPI
- 1104228600
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PH60470321 (WA)
- Practice address
- 1112 S M St
Tacoma, WA 98405-3654 - Phone
- (253) 572-7753
- NPI assigned
- Sep 16, 2014
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH60470321 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH60470321 | WA | Yes |
Addresses
Primary practice location
1112 S M St
Tacoma, WA 98405-3654
Mailing address
11607 SE 230TH PL
Kent, WA 98031-3746
Phone (206) 355-2872
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.