# FRED MEYER INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477931947
- **Authorized official:** JIM KILGUS PHARMD (PHARMACY MANAGER)
- **Authorized official phone:** (253) 826-8433

## Contact information

- **Practice address:** 1201 VALLEY AVE E, SUMNER, WA 98390-3225
- **Practice address phone:** (253) 826-8433
- **Mailing address:** 1201 VALLEY AVE E, SUMNER, WA 98390-3225

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | IR60290101 | WA | Yes |

## Other

- **Enumeration date:** 05/15/2015
- **Last updated:** 05/15/2015