Provider Demographics
NPI:1073889135
Name:AYYAGARI, UMA MAHESH (RPH)
Entity Type:Individual
Prefix:MR
First Name:UMA MAHESH
Middle Name:
Last Name:AYYAGARI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 AUBURN WAY N
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-4164
Mailing Address - Country:US
Mailing Address - Phone:253-931-5584
Mailing Address - Fax:
Practice Address - Street 1:801 AUBURN WAY N
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-4164
Practice Address - Country:US
Practice Address - Phone:253-931-5584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-22
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60151507183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist