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General NPI Number Information
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NPI Number | 1639479082
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Entity Type | Individual
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Provider Name | WILLIAM KING
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Gender | Male
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Dates
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Enumeration Date | 11/01/2010
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Last Update Date | 11/01/2010
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Provider Practice Location Address
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Address Line | 601 S PIONEER WAY
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City | MOSES LAKE
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State | WA
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Zip | 98837-4801
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Country | US
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Telephone | 509-764-4721
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Fax | 509-764-7412
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Provider Business Mailing Address
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Address Line | 601 S PIONEER WAY
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City | MOSES LAKE
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State | WA
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Zip | 98837-4801
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Country | US
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Telephone | 509-764-4721
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Fax | 509-764-7412
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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 | PH 00040152
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License Number State | WA
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