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General NPI Number Information
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NPI Number | 1831683507
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Entity Type | Individual
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Provider Name | SETH JACOB COLLINS
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Gender | Male
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Dates
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Enumeration Date | 06/18/2018
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Last Update Date | 03/15/2019
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Provider Practice Location Address
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Address Line | 4707 CALIFORNIA AVE SW
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City | SEATTLE
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State | WA
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Zip | 98116
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Country | US
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Telephone | 206-932-4225
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Fax | 206-938-3454
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Provider Business Mailing Address
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Address Line | 4707 CALIFORNIA AVE SW
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City | SEATTLE
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State | WA
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Zip | 98116-4412
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Country | US
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Telephone | 206-932-4225
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Fax | 206-938-3454
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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 | 41566
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 60868380
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License Number State | WA
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