Provider Demographics
NPI:1770906455
Name:SEATTLE CANCER TREATMENT AND WELLNESS CENTER - PHARMACY
Entity type:Organization
Organization Name:SEATTLE CANCER TREATMENT AND WELLNESS CENTER - PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAKVOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-204-5620
Mailing Address - Street 1:900 SW 16TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 SW 16TH ST STE 100
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2631
Practice Address - Country:US
Practice Address - Phone:425-204-5620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy