Healthcare Provider Details

I. General information

NPI: 1346645009
Provider Name (Legal Business Name): KATHRYN TRIESELMANN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2014
Last Update Date: 08/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 EASTLAKE AVE E
SEATTLE WA
98109-4405
US

IV. Provider business mailing address

825 EASTLAKE AVE E
SEATTLE WA
98109-4405
US

V. Phone/Fax

Practice location:
  • Phone: 206-288-6500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberPHA-PHA-LIC-55380
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberRPH-0012396
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberPH60167245
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: