MEDICARE: DR. RAYMOND WILLIAM HALLMEN III PHARMD

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
1	183500000X	Pharmacist	IR61180377	WA
2	183500000X	Pharmacist	PH70012522	WA

General Provider Information

NPI Number	:	1275427700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYMOND WILLIAM HALLMEN III PHARMD

Provider Business Mailing Address
First Line	:	15209 SUNWOOD BLVD APT B44
Second Line	:
City	:	TUKWILA
State	:	WA
Zip	:	98188-7720
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1540 NW GILMAN BLVD
Second Line	:
City	:	ISSAQUAH
State	:	WA
Zip	:	98027-5309
Country	:	US
Telephone Number	:	425-392-7500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2025
Last Update Date	:	06/06/2026

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