Healthcare Provider Details

I. General information

NPI: 1932049400
Provider Name (Legal Business Name): GREGORY GIPSON PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4333 BROOKLYN AVE NE
SEATTLE WA
98195-1016
US

IV. Provider business mailing address

4333 BROOKLYN AVE NE
SEATTLE WA
98195-1016
US

V. Phone/Fax

Practice location:
  • Phone: 206-597-4414
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60366806
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: