Healthcare Provider Details

I. General information

NPI: 1609384874
Provider Name (Legal Business Name): LENA PERRY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2018
Last Update Date: 01/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 BROADWAY
SEATTLE WA
98122
US

IV. Provider business mailing address

8803 8TH AVE NE
SEATTLE WA
98115-3005
US

V. Phone/Fax

Practice location:
  • Phone: 206-227-6510
  • Fax:
Mailing address:
  • Phone: 206-227-6510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPH60670737
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: