Healthcare Provider Details

I. General information

NPI: 1982911442
Provider Name (Legal Business Name): JRK PHARMA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2010
Last Update Date: 09/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21701 76TH AVE W STE 104 A
EDMONDS WA
98026-7536
US

IV. Provider business mailing address

21701 76TH AVE W STE 104 A
EDMONDS WA
98026-7536
US

V. Phone/Fax

Practice location:
  • Phone: 425-346-2148
  • Fax: 425-977-4881
Mailing address:
  • Phone: 425-346-2148
  • Fax: 425-977-4881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberPHAR.CF.60180646
License Number StateWA

VIII. Authorized Official

Name: MR. SAIKRISHNA ARUMILLI
Title or Position: OWNER
Credential: RPH
Phone: 425-346-2148