Terry Tyrrell, RPH

Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Enumclaw, WA

NPI 1669721072 · NPPES record last updated Aug 30, 2012

Key facts

NPI
1669721072
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
License
00011049 (WA)
Practice address
1455 Battersby Ave
Enumclaw, WA 98022-3634
Phone
(360) 802-8668
Fax
(360) 802-8669
NPI assigned
Aug 30, 2012
Sex
Male
Sole proprietor
No

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

LicenseStateTypeSpecialty
00011049WAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 00011049 WA Yes

Addresses

Primary practice location

1455 Battersby Ave
Enumclaw, WA 98022-3634

Mailing address

PO Box 218
Enumclaw, WA 98022-0218
Phone (360) 802-8668

Other providers in Enumclaw, WA

All providers in Enumclaw, WA · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Washington

Sources for this page

Verify at the official NPI Registry.