Provider Demographics
NPI:1255806360
Name:JUMA, SHEM O (RPH)
Entity type:Individual
Prefix:DR
First Name:SHEM
Middle Name:O
Last Name:JUMA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4215 S 30TH ST APT F138
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-3238
Mailing Address - Country:US
Mailing Address - Phone:972-859-0146
Mailing Address - Fax:
Practice Address - Street 1:4818 POINT FOSDICK DR NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1711
Practice Address - Country:US
Practice Address - Phone:253-851-6939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60864581183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist