Provider Demographics
NPI:1801206925
Name:IGNACIO, VANELLI GALANG (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:VANELLI
Middle Name:GALANG
Last Name:IGNACIO
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7140 LINDSAY AVE SE APT 102
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-8762
Mailing Address - Country:US
Mailing Address - Phone:360-550-8115
Mailing Address - Fax:
Practice Address - Street 1:7140 LINDSAY AVE SE APT 102
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-8762
Practice Address - Country:US
Practice Address - Phone:360-550-8115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60400751183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPH60400751OtherWA DOH PHARMACIST LICENSE