Provider Demographics
NPI:1245326719
Name:STEWART, ANGELA SUE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:SUE
Last Name:STEWART
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 1:21 GALA DRIVE
Mailing Address - Street 2:
Mailing Address - City:SELAH
Mailing Address - State:WA
Mailing Address - Zip Code:98942
Mailing Address - Country:US
Mailing Address - Phone:509-697-3127
Mailing Address - Fax:
Practice Address - Street 1:2811 TIETON DRIVE
Practice Address - Street 2:MEMORIAL HOSPITAL PHARMACY
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902
Practice Address - Country:US
Practice Address - Phone:509-577-5070
Practice Address - Fax:509-575-8700
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA156301835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy