Provider Demographics
NPI:1336123223
Name:HOOVER, MARILYN F (RPH)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:F
Last Name:HOOVER
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 1:5716 40TH AVENUE CT NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-8165
Mailing Address - Country:US
Mailing Address - Phone:253-858-8694
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:253-858-7460
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00018661183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist