Provider Demographics
NPI:1639472327
Name:BYMAN, SOFIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:SOFIA
Middle Name:
Last Name:BYMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9812 NE HIGHWAY 99
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-8935
Mailing Address - Country:US
Mailing Address - Phone:360-576-4902
Mailing Address - Fax:360-546-1597
Practice Address - Street 1:9812 NE HIGHWAY 99
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8935
Practice Address - Country:US
Practice Address - Phone:360-576-4902
Practice Address - Fax:360-546-1597
Is Sole Proprietor?:No
Enumeration Date:2010-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60084061183500000X
MN119965183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist