Healthcare Provider Details

I. General information

NPI: 1215372974
Provider Name (Legal Business Name): JOY IMADHAY PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2013
Last Update Date: 05/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15230 15TH AVE NE
SHORELINE WA
98155-7130
US

IV. Provider business mailing address

15230 15TH AVE NE
SHORELINE WA
98155-7130
US

V. Phone/Fax

Practice location:
  • Phone: 206-361-3565
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00052526
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: