Organization
IPSEN PHARMACY SERVICES LLC
Active
Other names
Clark's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN IPSEN (OWNER)
(425) 881-0222
Entity
Organization
Contact information
Practice address
15615 BEL RED RD, BELLEVUE, WA 98008-2300
(425) 881-0222
Mailing address
15615 BEL RED RD, SUITE B, BELLEVUE, WA 98008-2300
(425) 881-0222
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
PHAR.CF.6069307
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2166006
PK
—
Enumeration date
10/11/2016
Last updated
02/16/2017
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