Healthcare Provider Details

I. General information

NPI: 1841294303
Provider Name (Legal Business Name): LAURA JEAN GIFFORD RPH, CF
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7320 216TH ST SW STE 100
EDMONDS WA
98026-8006
US

IV. Provider business mailing address

20608 6TH PL W
LYNNWOOD WA
98036-7262
US

V. Phone/Fax

Practice location:
  • Phone: 425-673-3700
  • Fax: 425-673-3717
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00018768
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: