Provider Demographics
NPI:1093062242
Name:MORGAN, TINA ELAINE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:TINA
Middle Name:ELAINE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 22ND CT SE
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-5100
Mailing Address - Country:US
Mailing Address - Phone:253-435-0392
Mailing Address - Fax:
Practice Address - Street 1:2209 EAST 32ND ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98404-4922
Practice Address - Country:US
Practice Address - Phone:253-593-0232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00055228183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist