MARK BROCKWAY (NPI# 1962654970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962654970 |
| Entity Type | Individual |
| Full Name | MARK BROCKWAY |
| Credential | PHARMD, RPH |
| Practice Address |
2622 Meridian St S Health Care Resource Center Puyallup WA 98373-1500 |
| Practice Telephone | 2536972801 |
| Mailing Telephone | 2536972801 |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2008-10-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
PH00046796 | WA | Pharmacy Service Providers |
| Street Address |
2622 MERIDIAN ST S HEALTH CARE RESOURCE CENTER |
| City | PUYALLUP |
| State | WA |
| Zip Code | 98373-1500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801494711 | Caroline Brown Corbett | Dentist | 8012 112th St Ct E #320, Puyallup, WA 98373 | 2020-10-13 |
| 1629615760 | Jessie Jean Waiamau-ariota | Counselor | Winds of Liberty, 702 S Hill Park Dr Ste 206, Puyallup, WA 98373 | 2019-12-09 |
| 1194369181 | Ruba H Tawil | Dentist | 12005 Meridian E # 102, Puyallup, WA 98373 | 2019-11-01 |
| 1336621267 | Cara Tseng | Physician Assistant | 2940 S Meridian, Suite 200, Puyallup, WA 98373 | 2018-09-06 |
| 1902390289 | Melissa M Jenkins | Registered Nurse | 2920 S Meridian Ste 100, Puyallup, WA 98373 | 2018-06-19 |
| 1881141323 | Linda Cole | Massage Therapist | 8409 204th Street East, Spanaway, WA 98373 | 2016-09-01 |
| 1861855389 | Christina Leigh Bailey | Optometrist | 3500 S Meridian Ste 926, Puyallup, WA 98373 | 2016-04-01 |
| 1518301951 | Bryan Michael Swanson | Dentist | 2910 S Meridian Ste 120, Puyallup, WA 98373 | 2013-04-27 |
| 1760720569 | Vankosin Hewitt | Massage Therapist | 13613 Meridian East # 260, Puyallup, WA 98373 | 2013-01-29 |
| 1558607705 | Rosie Martinez | Counselor | 12812 101st Avenue Courte E, Suite 202, Puyallup, WA 98373 | 2012-12-17 |
| Find all providers in zip 98373 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083021521 | Nicholas Clayville | Pharmacist | 3909 10th St Se, Suite 2, Puyallup, WA 98374-2189 | 2014-07-16 |
| 1396973004 | Kirks Pharmacy At Hartland, Inc. | Pharmacist | 618 S Meridian, Puyallup, WA 98371-5999 | 2009-07-01 |
| 1174777486 | Jeffery Robert Williams | Pharmacist | 2622 S Meridian, Puyallup, WA 98373-1500 | 2008-11-13 |
| 1710998216 | Kirks Pharmacy At Sunrise Inc. | Pharmacist | 11212 Sunrise Blvd E Ste 204, Puyallup, WA 98374-8847 | 2006-08-10 |
| 1124460423 | Jamie Mazon | Pharmacist | 401 15th Ave Se, Puyallup, WA 98372-3715 | 2013-07-27 |
| 1922359363 | Charlie David Crow | Pharmacist | 1100 N Meridian, Puyallup, WA 98371-4403 | 2012-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395760 | Evelyn Tong | Pharmacist | 4229 122nd Ave Se, Bellevue, WA 98006-1915 | 2020-10-29 |
| 1356985345 | Nancy Celine Tran | Pharmacist | 906 S 38th Ct, Renton, WA 98055-5897 | 2019-11-01 |
| 1265087654 | Valorie Swensen | Pharmacist | 4500 Harrison St, Bellingham, WA 98229-3323 | 2019-08-02 |
| 1982110805 | Derek Matlock | Pharmacist | 3715 Ocean Beach Hwy # 2, Longview, WA 98632-4801 | 2017-12-15 |
| 1659880938 | Hazel Ann Feist | Pharmacist | 14406 Nw 20th Ave, Vancouver, WA 98685-8007 | 2017-09-29 |
| 1528586732 | Mayumi Robbins | Pharmacist | 410 9th Ave N Fl 7, Seattle, WA 98109-4708 | 2017-09-07 |
| 1699293688 | Jin Man Choe | Pharmacist | 105 W 8th Ave Ste 350, Spokane, WA 99204-2312 | 2017-08-30 |
| 1821457813 | Marie Cermak | Pharmacist | 12333 Ne 130th Ln # Lane415, Kirkland, WA 98034-7467 | 2016-02-18 |
| 1902281959 | Carmen Joy Berg | Pharmacist | 2320 South Salnave Road, Medical Lake, WA 99022 | 2015-07-20 |
| 1639574981 | Loi Chau | Pharmacist | 601 Broadway Rm 117, Seattle, WA 98122-5330 | 2014-10-29 |
| Find all providers with the same taxonomy | ||||
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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.