Provider Demographics
NPI:1891059457
Name:ROTONDO, MARY A (PHARMD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:A
Last Name:ROTONDO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 N 39TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-6388
Mailing Address - Country:US
Mailing Address - Phone:509-574-3404
Mailing Address - Fax:509-574-3420
Practice Address - Street 1:808 N 39TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-6388
Practice Address - Country:US
Practice Address - Phone:509-574-3404
Practice Address - Fax:509-574-3420
Is Sole Proprietor?:No
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 000186631835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology