Healthcare Provider Details

I. General information

NPI: 1871826750
Provider Name (Legal Business Name): JOSEPH M HENDRICKS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2009
Last Update Date: 09/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 16TH AVE
SEATTLE WA
98122-5699
US

IV. Provider business mailing address

550 16TH AVE
SEATTLE WA
98122-5699
US

V. Phone/Fax

Practice location:
  • Phone: 206-320-2484
  • Fax: 206-320-4568
Mailing address:
  • Phone: 206-320-2484
  • Fax: 206-320-4568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00017974
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: