Provider Demographics
NPI:1831499326
Name:BABA, EILEEN (RPH)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:BABA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 NE 162ND AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-3864
Mailing Address - Country:US
Mailing Address - Phone:360-944-2686
Mailing Address - Fax:360-944-2688
Practice Address - Street 1:6700 NE 162ND AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-3858
Practice Address - Country:US
Practice Address - Phone:360-944-2686
Practice Address - Fax:360-944-2688
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00021873183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist