Provider Demographics
NPI:1033327341
Name:HAGUE, ANDREA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:
Last Name:HAGUE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6305 BRIDGEPORT WAY W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98467-5117
Mailing Address - Country:US
Mailing Address - Phone:253-460-4033
Mailing Address - Fax:
Practice Address - Street 1:6305 BRIDGEPORT WAY W
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98467-5117
Practice Address - Country:US
Practice Address - Phone:253-460-4033
Practice Address - Fax:253-460-4027
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00059492183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist