Organization
MEDICINE MAN, INC.
Active
Other names
Medicine Man
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS ALAN HENDRICKS (OWNER)
(877) 789-0800
Entity
Organization
Contact information
Practice address
323 N 85TH ST, SEATTLE, WA 98103-3605
(877) 789-0800
(206) 781-8006
Mailing address
323 N 85TH ST, SEATTLE, WA 98103-3605
(877) 789-0800
(206) 781-8006
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
CF00004196
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6164701
—
WA
Enumeration date
02/21/2007
Last updated
02/09/2012
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