MEDICARE: NEIGHBORCARE HEALTH

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1679891402
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEIGHBORCARE HEALTH

Provider Business Mailing Address
First Line	:	905 SPRUCE ST STE 300
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98104-2474
Country	:	US
Telephone Number	:	206-367-0135
Fax Number	:	206-367-0150

Provider Business Practice Location Address
First Line	:	12736 33RD AVE NE
Second Line	:	SUITE 200
City	:	SEATTLE
State	:	WA
Zip	:	98125-4504
Country	:	US
Telephone Number	:	206-367-0135
Fax Number	:	206-367-0150

Authorized Official
Title or Position	:	PROVIDER ENROLLMENT SPECIALIST
Name	:	MS. AMANDA L LANGAN
Credential	:
Telephone Number	:	206-548-3114

Provider Enumeration Date	:	05/04/2010
Last Update Date	:	06/12/2013

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Directions to “NEIGHBORCARE HEALTH ” Practice Location

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