Provider Demographics
NPI:1447895099
Name:CHURCHILL, SYLVIA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:
Last Name:CHURCHILL
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 1:3136 SW 302ND PL
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-2342
Mailing Address - Country:US
Mailing Address - Phone:253-219-3955
Mailing Address - Fax:
Practice Address - Street 1:737 LOGAN AVE N
Practice Address - Street 2:BLDG 4-04
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055
Practice Address - Country:US
Practice Address - Phone:253-219-3955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00018074183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist