Provider Demographics
NPI:1750714788
Name:PANGELINAN, MICHELLE DARLENE (PHARMD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:DARLENE
Last Name:PANGELINAN
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 1:915 CAPITOL WAY S
Mailing Address - Street 2:UNIT #10
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1231
Mailing Address - Country:US
Mailing Address - Phone:520-360-6379
Mailing Address - Fax:
Practice Address - Street 1:3215 HARRISON AVE NW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8704
Practice Address - Country:US
Practice Address - Phone:360-943-1830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60389473183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist