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General NPI Number Information
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NPI Number | 1578750147
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Entity Type | Individual
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Provider Name | GAETANO J FORTE R.PH.
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Gender | Male
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 09/27/2007
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Provider Practice Location Address
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Address Line | 801 BROADWAY SUITE 100
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City | SEATTLE
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State | WA
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Zip | 98122-4396
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Country | US
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Telephone | 206-382-2087
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Fax | 206-382-4342
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Provider Business Mailing Address
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Address Line | 1226 ANANDA PL NW
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110-2727
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Country | US
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Telephone | 206-353-1425
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Fax | 888-300-8305
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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 | PH00019984
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License Number State | WA
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