Healthcare Provider Details

I. General information

NPI: 1285603555
Provider Name (Legal Business Name): ANN K WITTKOWSKY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 206-598-5626
  • Fax: 206-598-6217
Mailing address:
  • Phone: 206-598-5626
  • Fax: 206-598-6217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPH00011572
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: