Provider Demographics
NPI:1265878540
Name:STOKER, CALLIE (PHARMD)
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:
Last Name:STOKER
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 1:2525 FOREST RIDGE DR SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-7025
Mailing Address - Country:US
Mailing Address - Phone:253-939-2563
Mailing Address - Fax:
Practice Address - Street 1:702 TROSPER RD SW
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-6934
Practice Address - Country:US
Practice Address - Phone:360-943-5178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00040511183500000X
CARPH56903183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist