STACI MACK (NPI# 1366051401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366051401 |
| Entity Type | Individual |
| Full Name | STACI MACK |
| Other Name | STACI MATSUMOTO |
| Credential | PHARMD |
| Practice Address |
17927 97th Ln E Puyallup WA 98375-6319 |
| Practice Telephone | 2532300743 |
| Mailing Telephone | 2532300743 |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2020-07-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | P4.61086570 | WA | Pharmacy Service Providers |
| Street Address |
17927 97TH LN E |
| City | PUYALLUP |
| State | WA |
| Zip Code | 98375-6319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673817 | Cheryl Dann | Registered Nurse | 7224 Pacific Highway E, Milton, WA 98375 | 2019-11-07 |
| 1326554601 | Jasmanpreet Kaur Sidhu | Nurse's Aide | 17003 83rd Ave Cte, Puyallup, WA 98375 | 2017-12-21 |
| 1295257137 | Rafael Martin Morones IIi | Registered Nurse | 17802 87th Ave E, Puyallup, WA 98375 | 2017-07-12 |
| 1467990556 | Tessa D Parker | Massage Therapist | 17528 Meridian E Suite 207, Puyallup, WA 98375 | 2017-02-08 |
| 1144674326 | June Park | Social Worker | 9414 185th Street Ct E, Puyallup, WA 98375 | 2016-04-14 |
| 1417384348 | Washington Dental Corporation, PC | Dentist | 16810 Meridian East Suite J107, Puyallup, WA 98375 | 2013-10-10 |
| 1861825663 | L&t Chinese Medicine LLC | Acupuncturist | 16515 Meridian E., Ste. 200b, Puyallup, WA 98375 | 2013-08-15 |
| 1508110081 | Jennifer Gillings | Speech-Language Pathologist | 17418 74th Ave E, Puyallup, WA 98375 | 2012-11-05 |
| 1275887267 | Andrew Nelson Smith | Pharmacist | 14308 Meridian Ave E., Puyallup, WA 98375 | 2012-10-30 |
| 1538440714 | Zorawar Singh | Dentist | 16810 Meridian E Suite J107, Puyallup, CA 98375 | 2011-09-01 |
| Find all providers in zip 98375 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376024638 | David Aaron Edward Corey | Pharmacist | 2130 W Pioneer, Puyallup, WA 98371-5266 | 2018-08-24 |
| 1710497284 | Gerald Conner Mcfaul | Pharmacist | 3909 10th St Se # 102, Puyallup, WA 98374-2189 | 2017-10-10 |
| 1770039471 | Mahalakshmi Hariharan | Pharmacist | 2117 28th St Se, Puyallup, WA 98372 | 2016-09-01 |
| 1649680307 | Jason Farmer | Pharmacist | 17719 75th Ave E, Puyallup, WA 98375-3306 | 2014-05-04 |
| 1912340951 | Joanne Sorenson Iverson | Pharmacist | 3007 41st St Se, Puyallup, WA 98374-1740 | 2013-04-09 |
| 1275887267 | Andrew Nelson Smith | Pharmacist | 14308 Meridian Ave E., Puyallup, WA 98375 | 2012-10-30 |
| 1336498922 | Allen Shih | Pharmacist | 11012 Canyon Rd. East, Puyallup, WA 98373 | 2012-08-29 |
| 1316259104 | Vani Somasundaram | Pharmacist | 12811 Meridian E, Puyallup, WA 98373-5646 | 2010-07-08 |
| 1093035131 | Hee Do Park | Pharmacist | 9502 176th St E, Puyallup, WA 98375-9300 | 2010-06-10 |
| 1336469584 | Sanette Severance | Pharmacist | 11220 Canyon Rd E, Puyallup, WA 98373-4354 | 2010-06-09 |
| Find all providers in PUYALLUP | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.