Provider Demographics
NPI:1467445882
Name:THOMPSON, DARRELL W (RPH)
Entity type:Individual
Prefix:
First Name:DARRELL
Middle Name:W
Last Name:THOMPSON
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 1:406 SHERIDAN PL
Mailing Address - Street 2:
Mailing Address - City:STEILACOOM
Mailing Address - State:WA
Mailing Address - Zip Code:98388-3034
Mailing Address - Country:US
Mailing Address - Phone:253-278-6844
Mailing Address - Fax:
Practice Address - Street 1:WESTERN STATE HOSPITAL
Practice Address - Street 2:9601 STEILACOOM BLVD. SW
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98498-7213
Practice Address - Country:US
Practice Address - Phone:253-756-2521
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00011229183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist