Provider Demographics
NPI:1912126038
Name:DANDRIDGE, MERIDITH BATES (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MERIDITH
Middle Name:BATES
Last Name:DANDRIDGE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10824 SW 116TH ST
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-3026
Mailing Address - Country:US
Mailing Address - Phone:425-205-9530
Mailing Address - Fax:
Practice Address - Street 1:10824 SW 116TH ST
Practice Address - Street 2:
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070-3026
Practice Address - Country:US
Practice Address - Phone:425-205-9530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7805183500000X
WAPH000696031835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2027585Medicaid