Healthcare Provider Details

I. General information

NPI: 1033457205
Provider Name (Legal Business Name): SBK PHARMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2013
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7315 212TH ST SW SUITE 100
EDMONDS WA
98026-7610
US

IV. Provider business mailing address

7315 212TH ST SW SUITE 100
EDMONDS WA
98026-7610
US

V. Phone/Fax

Practice location:
  • Phone: 425-778-7778
  • Fax: 425-778-7888
Mailing address:
  • Phone: 425-778-7778
  • Fax: 425-778-7888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHAR.CF.60337707
License Number StateWA

VIII. Authorized Official

Name: DR. HARIKRISHNA SAJJA
Title or Position: PHARMACIST-IN-CHARGE
Credential: RPH, PHD
Phone: 425-778-7778