Provider Demographics
NPI:1831447705
Name:QFC
Entity type:Organization
Organization Name:QFC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:GUNN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:425-869-7474
Mailing Address - Street 1:8867 161ST AVE NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3585
Mailing Address - Country:US
Mailing Address - Phone:425-869-7474
Mailing Address - Fax:425-869-0580
Practice Address - Street 1:8867 161ST AVE NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3585
Practice Address - Country:US
Practice Address - Phone:425-869-7474
Practice Address - Fax:425-869-0580
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KROGER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-26
Last Update Date:2012-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH000107873336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy