Provider Demographics
NPI:1922388958
Name:NOMURA, CHRISTOPHER MASAHIRO (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MASAHIRO
Last Name:NOMURA
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 1:19651 STATE ROUTE 2
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272-1537
Mailing Address - Country:US
Mailing Address - Phone:360-794-9644
Mailing Address - Fax:360-794-0734
Practice Address - Street 1:19651 STATE ROUTE 2
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-1537
Practice Address - Country:US
Practice Address - Phone:360-794-9644
Practice Address - Fax:360-794-0734
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00064512183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist