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NPI Code Detail

MEDICARE: MERIDAN KIMBALL PICKETT

MEDICARE: MERIDAN KIMBALL PICKETT
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
1183500000XPharmacistPH60962956WA
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistPH60962956WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PH60962956OTHERWAPHARMACIST LICENSE

General Provider Information

NPI Number : 1891341715
Entity Type Code : Individual
Provider Name (Legal Business Name) : MERIDAN KIMBALL PICKETT
Provider Business Mailing Address
First Line : 990 E WASHINGTON ST
Second Line :
City : SEQUIM
State : WA
Zip : 98382-3517
Country : US
Telephone Number : 360-683-1156
Fax Number :
Provider Business Practice Location Address
First Line : 990 E WASHINGTON ST
Second Line :
City : SEQUIM
State : WA
Zip : 98382-3517
Country : US
Telephone Number : 360-683-1156
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2019
Last Update Date : 12/13/2023

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Directions to “ MERIDAN KIMBALL PICKETT ” Practice Location

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