Miracle Ruth Edison, ph60920591
Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Bellevue, WA. Individual provider (NPI-1).
Details
- NPI
- 1003461260
- Entity type
- Individual (NPI-1)
- Name
- Miracle Ruth Edison
- Credential
- ph60920591
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 5, 2019
- Last updated
- Aug 5, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1835P0018X | Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 60920591 | WA | Yes |
Practice location
3620 Factoria Blvd SeBellevue, WA 98006-6128
Phone 425-644-7529
Mailing address
3620 Factoria Blvd SeBellevue, WA 98006-6128
Phone 425-644-7529 · Fax 425-502-5482
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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