Healthcare Provider Details

I. General information

NPI: 1578542635
Provider Name (Legal Business Name): RAYMOND JASPER MORROW RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 12/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14277 PACIFIC HWY S
TUKWILA WA
98168-4124
US

IV. Provider business mailing address

12725 SE 167TH ST
RENTON WA
98058-5541
US

V. Phone/Fax

Practice location:
  • Phone: 206-431-9652
  • Fax: 206-431-0470
Mailing address:
  • Phone: 425-271-7481
  • Fax: 206-431-0470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00011203
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: