Healthcare Provider Details

I. General information

NPI: 1023535945
Provider Name (Legal Business Name): GARRETT KOBAYASHI PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2017
Last Update Date: 08/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 16TH AVE E
SEATTLE WA
98112-5226
US

IV. Provider business mailing address

1400 LAKE WASHINGTON BLVD N APT C109
RENTON WA
98056-6402
US

V. Phone/Fax

Practice location:
  • Phone: 206-326-2880
  • Fax:
Mailing address:
  • Phone: 808-348-9020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60706121
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: