Provider Demographics
NPI:1225303175
Name:ENG, PETER WAY (RPH)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:WAY
Last Name:ENG
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 1:7411 NE 117TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-4706
Mailing Address - Country:US
Mailing Address - Phone:360-896-3533
Mailing Address - Fax:360-896-3527
Practice Address - Street 1:7411 NE 117TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-4706
Practice Address - Country:US
Practice Address - Phone:360-896-3533
Practice Address - Fax:360-896-3527
Is Sole Proprietor?:No
Enumeration Date:2012-03-11
Last Update Date:2012-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 00015097183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist