Provider Demographics
NPI:1821385667
Name:ELIM PHARMACEUTICAL CONSULTANTS, LLC.
Entity type:Organization
Organization Name:ELIM PHARMACEUTICAL CONSULTANTS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PHARMACIST CONSULTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:GANA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, CGP
Authorized Official - Phone:425-908-7045
Mailing Address - Street 1:16125 JUANITA-WOOD WAY NE UNIT 2214
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-9444
Mailing Address - Country:US
Mailing Address - Phone:425-908-7045
Mailing Address - Fax:
Practice Address - Street 1:16125 JUANITA-WOOD WAY NE UNIT 2214
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-9444
Practice Address - Country:US
Practice Address - Phone:425-908-7045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602856613261Q00000X
WAPH00045962261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center