Provider Demographics
NPI:1356818546
Name:KHONGKHANGAM DAVILA, CHRISTOPHER KAHN (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:KAHN
Last Name:KHONGKHANGAM DAVILA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 62ND STREET CT E
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98443-1406
Mailing Address - Country:US
Mailing Address - Phone:253-347-2361
Mailing Address - Fax:
Practice Address - Street 1:17617 VASHON HWY SW
Practice Address - Street 2:
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070-4682
Practice Address - Country:US
Practice Address - Phone:206-463-9118
Practice Address - Fax:206-463-6950
Is Sole Proprietor?:No
Enumeration Date:2018-10-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60870886183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist