Provider Demographics
NPI:1497736417
Name:LIIKALA, FAITH MCDEVITT (RPH)
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:MCDEVITT
Last Name:LIIKALA
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 1:175 SE ANDREWS ST
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-3419
Mailing Address - Country:US
Mailing Address - Phone:425-392-8650
Mailing Address - Fax:425-391-8624
Practice Address - Street 1:450 NW GILMAN BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-2483
Practice Address - Country:US
Practice Address - Phone:425-392-8650
Practice Address - Fax:425-391-8624
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00013714183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist