Provider Demographics
NPI:1275242059
Name:CAGLE, PATTI
Entity Type:Individual
Prefix:
First Name:PATTI
Middle Name:
Last Name:CAGLE
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 1:4838 NW ELDORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-1124
Mailing Address - Country:US
Mailing Address - Phone:360-271-3750
Mailing Address - Fax:
Practice Address - Street 1:27000 MILLER BAY RD NE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:WA
Practice Address - Zip Code:98346-9371
Practice Address - Country:US
Practice Address - Phone:360-297-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician