Healthcare Provider Details

I. General information

NPI: 1881691871
Provider Name (Legal Business Name): MICHAEL GEORGE CAP RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 01/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 EASTLAKE AVE E # G5900 BOX 19023
SEATTLE WA
98109-4405
US

IV. Provider business mailing address

1959 NE PACIFIC ST MAILBOX 356015
SEATTLE WA
98195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 206-288-1381
  • Fax: 206-288-1387
Mailing address:
  • Phone: 206-598-6060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00046151
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP038909L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: