Provider Demographics
NPI:1558623595
Name:NAICKER, SALONA
Entity Type:Individual
Prefix:MRS
First Name:SALONA
Middle Name:
Last Name:NAICKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12811 BEVERLY PARK RD
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-5126
Mailing Address - Country:US
Mailing Address - Phone:425-347-3145
Mailing Address - Fax:
Practice Address - Street 1:12811 BEVERLY PARK RD
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-5126
Practice Address - Country:US
Practice Address - Phone:425-347-3145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00065852183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist