Provider Demographics
NPI:1295022093
Name:CALLIHAN, LOUISE A (RPH)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:A
Last Name:CALLIHAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 S 23RD ST
Mailing Address - Street 2:T-0341
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1603
Mailing Address - Country:US
Mailing Address - Phone:253-414-0303
Mailing Address - Fax:253-414-0303
Practice Address - Street 1:3320 S 23RD ST
Practice Address - Street 2:T-0341
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1603
Practice Address - Country:US
Practice Address - Phone:253-414-0303
Practice Address - Fax:253-414-0303
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 00021762183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist