Provider Demographics
NPI:1699100271
Name:SKURDAL, NORM (RPH)
Entity type:Individual
Prefix:MR
First Name:NORM
Middle Name:
Last Name:SKURDAL
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 1:32165 SR 20
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-3774
Mailing Address - Country:US
Mailing Address - Phone:360-679-5546
Mailing Address - Fax:360-679-0403
Practice Address - Street 1:32165 SR 20
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-3774
Practice Address - Country:US
Practice Address - Phone:360-679-5546
Practice Address - Fax:360-679-0403
Is Sole Proprietor?:No
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 00040157183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist