Provider Demographics
NPI:1780800458
Name:TAYAG, MA PRISCILLA ARCE
Entity type:Individual
Prefix:
First Name:MA PRISCILLA
Middle Name:ARCE
Last Name:TAYAG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MA PRISCILLA
Other - Middle Name:CASTANEDA
Other - Last Name:ARCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:6908 S 12TH ST APT 1908
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98465-1710
Mailing Address - Country:US
Mailing Address - Phone:253-507-5156
Mailing Address - Fax:
Practice Address - Street 1:1850 S MILDRED ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98465-1608
Practice Address - Country:US
Practice Address - Phone:253-460-9599
Practice Address - Fax:253-460-5998
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH66396183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist