Healthcare Provider Details

I. General information

NPI: 1548615776
Provider Name (Legal Business Name): IZABELA WOJNAROWICZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2016
Last Update Date: 04/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 SE EVERETT MALL WAY
EVERETT WA
98208-3208
US

IV. Provider business mailing address

205 211TH PL NE
SAMMAMISH WA
98074-3911
US

V. Phone/Fax

Practice location:
  • Phone: 425-238-9081
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60498893
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: