Provider Demographics
NPI:1003081977
Name:WAUGH, MICHELE ANN (RPH)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:ANN
Last Name:WAUGH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11302 VIPOND DR NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98395
Mailing Address - Country:US
Mailing Address - Phone:253-720-1920
Mailing Address - Fax:253-857-7679
Practice Address - Street 1:COSTLESS SENIOR SERVICES
Practice Address - Street 2:14216 92ND AVE NW
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98329
Practice Address - Country:US
Practice Address - Phone:253-857-7677
Practice Address - Fax:253-857-2983
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH10000143471835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6143101Medicaid
WA6143101Medicaid