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General NPI Number Information
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NPI Number | 1750413829
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Entity Type | Organization
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Legal Business Name | MARKET STREET PHARMACY
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1723 NW MARKET ST
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City | SEATTLE
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State | WA
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Zip | 98107-5225
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Country | US
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Telephone | 206-783-2960
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Fax | 206-784-7522
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Provider Business Mailing Address
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Address Line | 1723 NW MARKET ST
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City | SEATTLE
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State | WA
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Zip | 98107-5225
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Country | US
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Telephone | 206-783-2960
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Fax | 206-784-7522
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOHN STIMAC
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Credential |
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Telephone | 206-783-2960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | VA00013336
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License Number State | WA
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