Provider Demographics
NPI:1700139193
Name:PAAU, ELIZABETH RACHEL
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:RACHEL
Last Name:PAAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7014 W MERCER LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85345-6009
Mailing Address - Country:US
Mailing Address - Phone:760-815-7797
Mailing Address - Fax:
Practice Address - Street 1:744 W CAMELBACK RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-2207
Practice Address - Country:US
Practice Address - Phone:602-279-9337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZI010123183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist