Provider Demographics
NPI:1295467363
Name:HILARIO, ANGELICA PEARL JAVIER
Entity Type:Individual
Prefix:
First Name:ANGELICA PEARL
Middle Name:JAVIER
Last Name:HILARIO
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 1:8610 62ND AVENUE CT SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-5250
Mailing Address - Country:US
Mailing Address - Phone:253-219-5514
Mailing Address - Fax:
Practice Address - Street 1:5500 OLYMPIC DR
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1487
Practice Address - Country:US
Practice Address - Phone:253-858-7455
Practice Address - Fax:253-858-7444
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA61019936183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician