Provider Demographics
NPI:1619563988
Name:GICHINGA, ALVIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALVIN
Middle Name:
Last Name:GICHINGA
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 1:7320 163RD ST E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98375-7273
Mailing Address - Country:US
Mailing Address - Phone:302-525-9430
Mailing Address - Fax:
Practice Address - Street 1:7320 163RD ST E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98375-7273
Practice Address - Country:US
Practice Address - Phone:302-525-9430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX47853183500000X
FLPS61542183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist