Healthcare Provider Details

I. General information

NPI: 1346217007
Provider Name (Legal Business Name): EMILY MATTHIS ARMANTROUT RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 05/01/2020
Certification Date: 05/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16315 NE 87TH ST STE B6
REDMOND WA
98052-3537
US

IV. Provider business mailing address

13326 186TH AVE NE
WOODINVILLE WA
98072-6309
US

V. Phone/Fax

Practice location:
  • Phone: 425-822-1697
  • Fax:
Mailing address:
  • Phone: 425-830-5476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00054129
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: