Provider Demographics
NPI:1861721896
Name:MA, KATIE W (RPH)
Entity type:Individual
Prefix:MS
First Name:KATIE
Middle Name:W
Last Name:MA
Suffix:
Gender:F
Credentials:RPH
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Mailing Address - Street 1:2979 SQUALICUM PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1813
Mailing Address - Country:US
Mailing Address - Phone:360-788-6934
Mailing Address - Fax:360-788-6935
Practice Address - Street 1:2979 SQUALICUM PKWY STE 101
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1813
Practice Address - Country:US
Practice Address - Phone:360-788-6934
Practice Address - Fax:360-788-6935
Is Sole Proprietor?:No
Enumeration Date:2009-12-22
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAPH00042938183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist