Provider Demographics
NPI:1083923528
Name:TAPAWAN, MARIE JOY PINEDA
Entity Type:Individual
Prefix:
First Name:MARIE JOY
Middle Name:PINEDA
Last Name:TAPAWAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3703 W KENNEWICK AVE
Mailing Address - Street 2:APT C123
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-2867
Mailing Address - Country:US
Mailing Address - Phone:509-619-4113
Mailing Address - Fax:
Practice Address - Street 1:215 N 4TH AVE
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-5322
Practice Address - Country:US
Practice Address - Phone:509-547-2231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60178196183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist