Basava Purna Tiyyagura

NPI #1467797704 in Lacey, Washington

Provider Information

NPI Number: 1467797704
Entity Type: Individual
Name: Basava Purna Tiyyagura
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: Nov 27, 2012
Last Updated: Nov 27, 2012

Practice Location

Address: 8230 MARTIN WAY E
City: Lacey
State: Washington
ZIP Code: 98516-5726
Phone: (360) 456-0444

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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