Provider Demographics
NPI:1295711588
Name:FORSETH, MAURICE EDWARD JR (PHARMD)
Entity type:Individual
Prefix:MR
First Name:MAURICE
Middle Name:EDWARD
Last Name:FORSETH
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 POINT FOSDICK DR NW STE 215
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1700
Mailing Address - Country:US
Mailing Address - Phone:253-530-8068
Mailing Address - Fax:
Practice Address - Street 1:4545 POINT FOSDICK DR NW STE 215
Practice Address - Street 2:203
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1700
Practice Address - Country:US
Practice Address - Phone:253-530-8068
Practice Address - Fax:253-530-8069
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH000163301835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology