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Organization
MTM CLINICAL CARE RX
Active
Organization
MTM CLINICAL CARE RX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE V LE RPH (MTM PHARMACIST)
(206) 913-9664
Entity
Organization
Contact information
Practice address
620 SE EVERETT MALL WAY STE 210B, EVERETT, WA 98208-3249
(206) 913-9664
Mailing address
20531 76TH AVE SE, SNOHOMISH, WA 98296-5166
(206) 913-9664
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1477966612
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477966612
MEDICARE PART-D
WA
05
—
1477966612
—
WA
Enumeration date
09/09/2017
Last updated
06/16/2018
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