Provider Demographics
NPI:1922787951
Name:GUZMAN, ELISA DANIELLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ELISA
Middle Name:DANIELLE
Last Name:GUZMAN
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 1:9209 CHARDONNAY DR
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-3311
Mailing Address - Country:US
Mailing Address - Phone:509-554-2552
Mailing Address - Fax:
Practice Address - Street 1:5506 ROAD 68
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-9627
Practice Address - Country:US
Practice Address - Phone:509-547-1789
Practice Address - Fax:509-547-9263
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61446459183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist