Provider Demographics
NPI:1851673222
Name:MAYO, JOSEPHINE G (RPH)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:G
Last Name:MAYO
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 1:10990 HARBOR HILL DR NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-8945
Mailing Address - Country:US
Mailing Address - Phone:253-853-8609
Mailing Address - Fax:253-853-8606
Practice Address - Street 1:10990 HARBOR HILL DR NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-8945
Practice Address - Country:US
Practice Address - Phone:253-853-8609
Practice Address - Fax:253-853-8606
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00013704183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist