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General NPI Number Information
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NPI Number | 1982934865
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Entity Type | Individual
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Provider Name | NICHOLAS D FIRESTINE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/28/2009
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Last Update Date | 12/28/2009
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Provider Practice Location Address
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Address Line | 4404 S 160TH ST
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City | TUKWILA
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State | WA
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Zip | 98188-2755
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Country | US
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Telephone | 206-353-2768
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 69750
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City | SEATTLE
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State | WA
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Zip | 98168-8750
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Country | US
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Telephone | 206-353-2768
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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 | PH00021313
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License Number State | WA
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