Provider Demographics
NPI:1336270180
Name:WARNER, GLORIA D (RPH)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:D
Last Name:WARNER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14618 206TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98059-8914
Mailing Address - Country:US
Mailing Address - Phone:425-226-9817
Mailing Address - Fax:
Practice Address - Street 1:20518 108TH AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-1542
Practice Address - Country:US
Practice Address - Phone:253-854-8181
Practice Address - Fax:253-850-7631
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00013812183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist