Healthcare Provider Details

I. General information

NPI: 1770043622
Provider Name (Legal Business Name): NTEK CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 03/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12911 120TH AVE NE STE F260
KIRKLAND WA
98034-3053
US

IV. Provider business mailing address

2117 109TH AVE SE
BELLEVUE WA
98004-7312
US

V. Phone/Fax

Practice location:
  • Phone: 425-947-5151
  • Fax:
Mailing address:
  • Phone: 425-449-3097
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NATALIE CHUNG-A KIM
Title or Position: PRESIDENT
Credential: PHARM.D.
Phone: 425-947-5151