MEDICARE: MR. EDWARD K MATSUWAKA 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
1	183500000X	Pharmacist	14541	WA

General Provider Information

NPI Number	:	1598970584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EDWARD K MATSUWAKA RPH

Provider Business Mailing Address
First Line	:	720 7TH AVE
Second Line	:	SUITE 100
City	:	SEATTLE
State	:	WA
Zip	:	98104-1957
Country	:	US
Telephone Number	:	206-838-6070
Fax Number	:	206-838-9775

Provider Business Practice Location Address
First Line	:	720 7TH AVE
Second Line	:	SUITE 100
City	:	SEATTLE
State	:	WA
Zip	:	98104-1957
Country	:	US
Telephone Number	:	206-838-6070
Fax Number	:	206-838-9775

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2007
Last Update Date	:	08/29/2007

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