Anatole V Pavelko, R.PH
Individual provider Active NPI Pharmacist · Camano Island, WA
NPI 1659617843 · NPPES record last updated Dec 17, 2012
Key facts
- NPI
- 1659617843
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PH 00058683 (WA)
- Practice address
- 930 Michael Way
Camano Island, WA 98282-6521 - Phone
- (360) 547-6780
- NPI assigned
- Dec 17, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS6537 | FL | MD | Pharmacist |
| 05987 | NV | MD | Pharmacist |
| PH 00058683 | WA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH 00058683 | WA | Yes |
| Pharmacist | 183500000X | 05987 | NV | |
| Pharmacist | 183500000X | 27498 | CA | |
| Pharmacist | 183500000X | PS6537 | FL |
Addresses
Primary practice location
930 Michael Way
Camano Island, WA 98282-6521
Mailing address
930 Michael Way
Camano Island, WA 98282-6521
Phone (360) 547-6780
Other providers in Camano Island, WA
- Robin Ann Noe
- Lisanne Olsen
- Miranda Omelchenko
- Andrew Parker
- Mary Terese Parkwell
- Kimberly Ann Payne
- Christopher Perez
- Mark Dudley Phibbs
- Christine Allison Pitts
- Alicia Michelle Ponte
All providers in Camano Island, WA · Pharmacist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2012. 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.