Healthcare Provider Details

I. General information

NPI: 1982929907
Provider Name (Legal Business Name): KENDRA RAE CAWLEY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KENDRA RAE BISHOP PHARMD

II. Dates (important events)

Enumeration Date: 04/01/2010
Last Update Date: 06/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 N LANDING WAY
RENTON WA
98057-5521
US

IV. Provider business mailing address

1215 N LANDING WAY
RENTON WA
98057-5521
US

V. Phone/Fax

Practice location:
  • Phone: 425-207-0078
  • Fax:
Mailing address:
  • Phone: 425-207-0078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00070786
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: