MEDICARE: CAMERON HARTLEY

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	PH61581733	WA

General Provider Information

NPI Number	:	1780408724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMERON HARTLEY

Provider Business Mailing Address
First Line	:	2600 SW BARTON ST STE H1
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98126-3959
Country	:	US
Telephone Number	:	206-938-4253
Fax Number	:

Provider Business Practice Location Address
First Line	:	2600 SW BARTON ST STE H1
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98126-3959
Country	:	US
Telephone Number	:	206-938-4253
Fax Number	:

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

Provider Enumeration Date	:	11/14/2024
Last Update Date	:	11/14/2024

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Directions to “ CAMERON HARTLEY ” Practice Location

Language	Start Address	Practice Location

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