Healthcare Provider Details

I. General information

NPI: 1841295540
Provider Name (Legal Business Name): CHESTERFIELD PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 E UNION ST
SEATTLE WA
98122-2957
US

IV. Provider business mailing address

2301 E UNION ST
SEATTLE WA
98122-2957
US

V. Phone/Fax

Practice location:
  • Phone: 206-323-0147
  • Fax: 206-323-0368
Mailing address:
  • Phone: 206-323-0147
  • Fax: 206-323-0368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberCF00057419
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberCF00057419
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberCF00057419
License Number StateWA

VIII. Authorized Official

Name: PATRICK HENRY
Title or Position: PHARMACY MANAGER
Credential: PHARMD
Phone: 206-323-0147