Provider Demographics
NPI:1427057850
Name:FREDERICK, CINDY R (RPH)
Entity type:Individual
Prefix:MS
First Name:CINDY
Middle Name:R
Last Name:FREDERICK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:207 PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:STEILACOOM
Mailing Address - State:WA
Mailing Address - Zip Code:98388-2004
Mailing Address - Country:US
Mailing Address - Phone:253-756-2691
Mailing Address - Fax:253-756-3950
Practice Address - Street 1:9601 STEILACOOM BLVD SW
Practice Address - Street 2:WESTERN STATE HOSPITAL
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98498-7213
Practice Address - Country:US
Practice Address - Phone:253-756-2691
Practice Address - Fax:253-756-3950
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH000116241835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric