Provider Demographics
NPI:1366582595
Name:PAULEY, ANGELICA MERCEDES (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANGELICA
Middle Name:MERCEDES
Last Name:PAULEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MRS
Other - First Name:ANGELICA
Other - Middle Name:MERCEDES
Other - Last Name:PAULEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:8315 NORMANDY ST SE UNIT 63
Mailing Address - Street 2:
Mailing Address - City:EAST OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98540-1002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:OCEAN SHORES PHARMACY
Practice Address - Street 2:121 E. CHANCE-A-LA-MER
Practice Address - City:OCEAN SHORES
Practice Address - State:WA
Practice Address - Zip Code:98569
Practice Address - Country:US
Practice Address - Phone:360-289-4647
Practice Address - Fax:360-289-3812
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00065779183500000X
WAPH65779183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist