Healthcare Provider Details

I. General information

NPI: 1548525819
Provider Name (Legal Business Name): BARTELL DRUGS PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2012
Last Update Date: 07/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4727 DENVER AVE S
SEATTLE WA
98134-2316
US

IV. Provider business mailing address

4727 DENVER AVE S
SEATTLE WA
98134-2316
US

V. Phone/Fax

Practice location:
  • Phone: 206-763-2626
  • Fax: 206-767-1397
Mailing address:
  • Phone: 206-763-2626
  • Fax: 206-767-1397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberVA00070014
License Number StateWA

VIII. Authorized Official

Name: KHANH PHUONG NGUYEN
Title or Position: PHARMACY TECHNICIAN
Credential:
Phone: 206-878-4627