Healthcare Provider Details

I. General information

NPI: 1295035566
Provider Name (Legal Business Name): NICHOLAS DANIEL LAZIPONE PHARM.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2010
Last Update Date: 11/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 9TH AVE
SEATTLE WA
98101
US

IV. Provider business mailing address

1100 9TH AVE
SEATTLE WA
98101-2756
US

V. Phone/Fax

Practice location:
  • Phone: 206-583-6011
  • Fax:
Mailing address:
  • Phone: 206-583-6011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1983
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60359422
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: