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NPI Code Detail

MEDICARE: LAUREEN B. LILJEGREN R.PH.

MEDICARE:   LAUREEN B. LILJEGREN  R.PH.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPH00010290WA

General Provider Information

NPI Number : 1003890245
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREEN B. LILJEGREN R.PH.
Provider Business Mailing Address
First Line : 18407 NE 133RD ST
Second Line :
City : WOODINVILLE
State : WA
Zip : 98072-6340
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 526 228TH AVE NE
Second Line :
City : SAMMAMISH
State : WA
Zip : 98074-7226
Country : US
Telephone Number : 425-868-1112
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2005
Last Update Date : 01/14/2008

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Directions to “ LAUREEN B. LILJEGREN R.PH.” Practice Location

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