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NPI Code Detail

MEDICARE: MICHEAL HENRY PD

MEDICARE: MICHEAL HENRY PD
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
11835G0303XGeriatric PharmacistPH00020389WA

General Provider Information

NPI Number : 1174661805
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHEAL HENRY PD
Provider Business Mailing Address
First Line : 6503 52ND AVE NE
Second Line :
City : SEATTLE
State : WA
Zip : 98115-7744
Country : US
Telephone Number : 206-522-5784
Fax Number :
Provider Business Practice Location Address
First Line : 4831 35TH AVE SW
Second Line :
City : SEATTLE
State : WA
Zip : 98126-2709
Country : US
Telephone Number : 206-938-6196
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2007
Last Update Date : 03/15/2026

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