Provider Demographics
NPI:1104113794
Name:MCCOWN, ANDREWS R (RPH)
Entity type:Individual
Prefix:MR
First Name:ANDREWS
Middle Name:R
Last Name:MCCOWN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 S MERIDIAN
Mailing Address - Street 2:T-0342
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-3777
Mailing Address - Country:US
Mailing Address - Phone:253-864-4617
Mailing Address - Fax:253-864-4617
Practice Address - Street 1:3310 S MERIDIAN
Practice Address - Street 2:T-0342
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-3777
Practice Address - Country:US
Practice Address - Phone:253-864-4617
Practice Address - Fax:253-864-4617
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00010135183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist