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General NPI Number Information
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NPI Number | 1063493773
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Entity Type | Individual
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Provider Name | SOPHIA Z HUMPHREYS PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 11/29/2011
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Provider Practice Location Address
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Address Line | 15230 15TH AVE NE FIRCREST RHC PHARMACY DEPARTMENT
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City | SHORELINE
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State | WA
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Zip | 98155-7130
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Country | US
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Telephone | 206-361-3565
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Fax |
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Provider Business Mailing Address
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Address Line | 15230 15TH AVE NE
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City | SHORELINE
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State | WA
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Zip | 98155
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Country | US
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Telephone | 206-361-3565
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Fax | 206-361-3157
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PH00022476
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License Number State | WA
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