Organization
KING COUNTY FINANCE
Active
Other names
EASTGATE PUBLIC HEALTH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN ARDELL MOE (PRACTICE MANAGEMENT ADMINISTRATOR)
(206) 263-8807
Entity
Organization
Contact information
Practice address
14350 SE EASTGATE WAY, BELLEVUE, WA 98007-6458
(206) 477-8190
(206) 205-8980
Mailing address
14350 SE EASTGATE WAY, BELLEVUE, WA 98007-6458
(206) 296-4908
(206) 205-3095
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
PHAR.CF.60490760
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2108127
PK
—
05
—
6005060
—
WA
Enumeration date
11/28/2006
Last updated
10/13/2022
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