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General NPI Number Information
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NPI Number | 1104075589
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Entity Type | Individual
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Provider Name | JANET IRENE BLACK PHARMACIST
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Gender | Female
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Dates
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Enumeration Date | 09/10/2008
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Last Update Date | 09/10/2008
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Provider Practice Location Address
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Address Line | 19401 40TH AVENUE WEST SUITE 330 CAREER STAFF UNLIMITED
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City | LYNNWOOD
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State | WA
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Zip | 98036
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Country | US
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Telephone | 800-766-0122
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Fax | 866-835-5848
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Provider Business Mailing Address
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Address Line | 4626 244TH PL SE
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City | ISSAQUAH
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State | WA
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Zip | 98029
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Country | US
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Telephone | 425-891-6657
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Fax |
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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 | PH000010498
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License Number State | WA
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