Provider Demographics
NPI:1700038973
Name:GOWDA, ANAND N (RPH)
Entity Type:Individual
Prefix:
First Name:ANAND
Middle Name:N
Last Name:GOWDA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6417 83RD AVE W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98467-3902
Mailing Address - Country:US
Mailing Address - Phone:425-247-4108
Mailing Address - Fax:
Practice Address - Street 1:3840 BRIDGEPORT WAY W
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4416
Practice Address - Country:US
Practice Address - Phone:253-460-2875
Practice Address - Fax:253-460-2985
Is Sole Proprietor?:No
Enumeration Date:2008-10-18
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00069635183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist