Provider Demographics
NPI:1053611764
Name:HARKIN, ERICA (PHARM D)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:
Last Name:HARKIN
Suffix:
Gender:F
Credentials:PHARM D
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 560
Mailing Address - Street 2:
Mailing Address - City:YELM
Mailing Address - State:WA
Mailing Address - Zip Code:98597-0560
Mailing Address - Country:US
Mailing Address - Phone:253-370-2623
Mailing Address - Fax:
Practice Address - Street 1:1109 E YELM AVE
Practice Address - Street 2:
Practice Address - City:YELM
Practice Address - State:WA
Practice Address - Zip Code:98597-7683
Practice Address - Country:US
Practice Address - Phone:360-458-8835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 60141799183500000X
MT5685183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist