Provider Demographics
NPI:1174742084
Name:LASLO, TONYA M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TONYA
Middle Name:M
Last Name:LASLO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:M
Other - Last Name:VANCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14218 92ND AVE NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98329-8710
Mailing Address - Country:US
Mailing Address - Phone:253-857-7797
Mailing Address - Fax:253-857-7679
Practice Address - Street 1:14218 92ND AVE NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98329-8710
Practice Address - Country:US
Practice Address - Phone:253-857-7797
Practice Address - Fax:253-857-7679
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00050800183500000X, 1835P2201X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAWAPH00050800OtherPHARMACIST LICENSE