Provider Demographics
NPI:1417550450
Name:DIEKMANN, ZACHARY (PHARM D)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:DIEKMANN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11400 51ST AVE NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332
Mailing Address - Country:US
Mailing Address - Phone:253-858-7799
Mailing Address - Fax:
Practice Address - Street 1:11400 51ST AVE NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332
Practice Address - Country:US
Practice Address - Phone:253-858-7799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60968560183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist