Provider Demographics
NPI:1588729537
Name:ELIJAH, VICTORIA LP (PHARMD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:LP
Last Name:ELIJAH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23672
Mailing Address - Street 2:2640 SW 347TH ST.
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98093-0672
Mailing Address - Country:US
Mailing Address - Phone:253-952-8108
Mailing Address - Fax:
Practice Address - Street 1:1102 S I ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4559
Practice Address - Country:US
Practice Address - Phone:253-284-2324
Practice Address - Fax:253-284-4131
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00041498183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist