Organization
MUCKLESHOOT HEALTH AND WELLNESS CENTER PHARMACY
Active
Other names
Muckleshoot HWC Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW BERG PHARM D. (PHARMACY DIRECTOR)
(253) 333-3619
Entity
Organization
Contact information
Practice address
17500 SE 392ND ST, ATTN PHARMACY, AUBURN, WA 98092-9705
(253) 333-3618
(253) 333-6853
Mailing address
17500 SE 392ND ST, ATTN PHARMACY, AUBURN, WA 98092-9705
(253) 333-3618
(253) 333-6853
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
—
WA
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6016752
—
WA
Enumeration date
05/07/2007
Last updated
11/09/2016
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