Provider Demographics
NPI:1427311992
Name:CECCANTI, JAMES (PHARMACIST)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:CECCANTI
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2907 N 27TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98407-6309
Mailing Address - Country:US
Mailing Address - Phone:253-973-0333
Mailing Address - Fax:253-944-4075
Practice Address - Street 1:34503 9TH AVE S
Practice Address - Street 2:STE 110
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8727
Practice Address - Country:US
Practice Address - Phone:253-944-4040
Practice Address - Fax:253-944-4075
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00010719183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist