Provider Demographics
NPI:1417481805
Name:ALBRECHT, PRAJAKTA PALKAR (RPH)
Entity type:Individual
Prefix:
First Name:PRAJAKTA
Middle Name:PALKAR
Last Name:ALBRECHT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7168 COBI PL NW
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-6122
Mailing Address - Country:US
Mailing Address - Phone:318-537-0402
Mailing Address - Fax:
Practice Address - Street 1:3497 BETHEL RD SE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-5634
Practice Address - Country:US
Practice Address - Phone:360-874-9063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60717219183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist