Provider Demographics
NPI:1316260607
Name:BASHAW, RYAN F (PHARMD)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:F
Last Name:BASHAW
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1312 111TH STREET CT NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-7557
Mailing Address - Country:US
Mailing Address - Phone:253-858-1801
Mailing Address - Fax:253-756-5086
Practice Address - Street 1:4315 6TH AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-4014
Practice Address - Country:US
Practice Address - Phone:253-756-5159
Practice Address - Fax:253-756-5086
Is Sole Proprietor?:No
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00040804183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist