Provider Demographics
NPI:1497085161
Name:TAK, RAHUL V (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RAHUL
Middle Name:V
Last Name:TAK
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 1:27112 132ND AVE SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98042-7228
Mailing Address - Country:US
Mailing Address - Phone:253-638-3324
Mailing Address - Fax:253-638-3324
Practice Address - Street 1:27112 132ND AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98042-7228
Practice Address - Country:US
Practice Address - Phone:253-638-3324
Practice Address - Fax:253-638-3324
Is Sole Proprietor?:No
Enumeration Date:2010-01-01
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00056814183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist