Provider Demographics
NPI:1700863958
Name:ORWIG, BEV M
Entity Type:Individual
Prefix:
First Name:BEV
Middle Name:M
Last Name:ORWIG
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 1:24230 SE 380TH ST
Mailing Address - Street 2:
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022-8841
Mailing Address - Country:US
Mailing Address - Phone:360-825-2048
Mailing Address - Fax:
Practice Address - Street 1:22117 SE 237TH ST
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-8533
Practice Address - Country:US
Practice Address - Phone:425-432-1234
Practice Address - Fax:425-432-6756
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA00013042183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician