Healthcare Provider Details

I. General information

NPI: 1780945972
Provider Name (Legal Business Name): QFC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2012
Last Update Date: 06/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9999 HOLMAN RD NW
SEATTLE WA
98117-2041
US

IV. Provider business mailing address

9999 HOLMAN RD NW
SEATTLE WA
98117-2041
US

V. Phone/Fax

Practice location:
  • Phone: 206-782-4100
  • Fax: 206-784-7196
Mailing address:
  • Phone: 206-782-4100
  • Fax: 206-784-7196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number00056194
License Number StateWA

VIII. Authorized Official

Name: SARAH CHUNG
Title or Position: PHARMACIST
Credential: B.S. PHARMACY
Phone: 206-782-4100