Healthcare Provider Details

I. General information

NPI: 1578548913
Provider Name (Legal Business Name): CARROLL RAY STEINER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/08/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6720 E GREEN LAKE WAY N THE HEARTHSTONE
SEATTLE WA
98103-5439
US

IV. Provider business mailing address

6813 86TH ST E
PUYALLUP WA
98371-6449
US

V. Phone/Fax

Practice location:
  • Phone: 206-525-9666
  • Fax: 206-522-0190
Mailing address:
  • Phone: 253-848-1239
  • Fax: 253-848-4501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00007146
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: