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General NPI Number Information
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NPI Number | 1841690112
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Entity Type | Individual
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Provider Name | CHRISTOPHER MICHAEL DIBBLE
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Gender | Male
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Dates
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Enumeration Date | 08/24/2014
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Last Update Date | 08/24/2014
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Provider Practice Location Address
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Address Line | 5409 15TH AVE NW
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City | SEATTLE
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State | WA
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Zip | 98107-3810
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Country | US
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Telephone | 206-781-0056
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Fax |
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Provider Business Mailing Address
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Address Line | 1508 243RD PL SE
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City | BOTHELL
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State | WA
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Zip | 98021-8877
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Country | US
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Telephone | 425-248-9392
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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 | PH60484240
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License Number State | WA
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