Healthcare Provider Details

I. General information

NPI: 1083537278
Provider Name (Legal Business Name): NATHAN OLIVER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

4800 SAND POINT WAY NE
SEATTLE WA
98105-3901
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-6262
  • Fax: 206-985-3210
Mailing address:
  • Phone: 206-987-6262
  • Fax: 206-985-3210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH.61304092
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: