Provider Demographics
NPI:1134406689
Name:HIRAYAMA, MAKANANI (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MAKANANI
Middle Name:
Last Name:HIRAYAMA
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 1:3320 S 23RD ST
Mailing Address - Street 2:T-0341
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1603
Mailing Address - Country:US
Mailing Address - Phone:253-414-0303
Mailing Address - Fax:253-414-0303
Practice Address - Street 1:3320 S 23RD ST
Practice Address - Street 2:T-0341
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1603
Practice Address - Country:US
Practice Address - Phone:253-414-0303
Practice Address - Fax:253-414-0303
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-11
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60217617183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist