Provider Demographics
NPI:1245613686
Name:WEAVER, STACY RIGUIS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STACY
Middle Name:RIGUIS
Last Name:WEAVER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10725 MCDONALD RD SW
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98498-1921
Mailing Address - Country:US
Mailing Address - Phone:360-485-8796
Mailing Address - Fax:
Practice Address - Street 1:1708 YAKIMA AVE
Practice Address - Street 2:SUITE 20
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-5307
Practice Address - Country:US
Practice Address - Phone:360-485-8796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 60466462183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist