Provider Demographics
NPI:1710611777
Name:WANGADI, JOSHUA L (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:L
Last Name:WANGADI
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 1:16626 6TH AVE W APT G202
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-8814
Mailing Address - Country:US
Mailing Address - Phone:206-407-7802
Mailing Address - Fax:
Practice Address - Street 1:6807 EVERGREEN WAY
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-5145
Practice Address - Country:US
Practice Address - Phone:425-438-9380
Practice Address - Fax:425-438-2559
Is Sole Proprietor?:No
Enumeration Date:2022-07-14
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIR608792661835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist