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General NPI Number Information
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NPI Number | 1003974379
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Entity Type | Organization
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Legal Business Name | J & J PHARMACY
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7315 212TH ST SW STE 102
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City | EDMONDS
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State | WA
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Zip | 98026-7610
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Country | US
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Telephone | 425-670-8912
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Fax |
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Provider Business Mailing Address
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Address Line | 7315 212TH ST SW STE 102
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City | EDMONDS
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State | WA
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Zip | 98026-7610
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Country | US
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Telephone | 425-670-8912
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Fax |
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Authorized Official
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Title or Position | OWNER PHARMACIST
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Name | STEPHEN C JOHNSON
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Credential | RPH
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Telephone | 425-670-8912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 04146
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License Number State | WA
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