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NPI Code Detail

MEDICARE: KENNETH IAN MAIN RPH

MEDICARE: KENNETH IAN MAIN RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist00009937WA

General Provider Information

NPI Number : 1346502044
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH IAN MAIN RPH
Provider Business Mailing Address
First Line : 9999 HOLMAN RD NW
Second Line :
City : SEATTLE
State : WA
Zip : 98117-2041
Country : US
Telephone Number : 206-782-4100
Fax Number : 206-784-7196
Provider Business Practice Location Address
First Line : 9999 HOLMAN RD NW
Second Line :
City : SEATTLE
State : WA
Zip : 98117-2041
Country : US
Telephone Number : 206-782-4100
Fax Number : 206-784-7196
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2012
Last Update Date : 06/09/2012

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Directions to “ KENNETH IAN MAIN RPH” Practice Location

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