Individual
ROBERT BRENT WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1030 AVENUE D STE 2, SNOHOMISH, WA 98290-2086
(360) 863-3009
(844) 375-4097
Mailing address
10330 MERIDIAN AVE N STE 180, SEATTLE, WA 98133-9496
(206) 368-6060
(206) 368-6061
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
PH00011060
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003118
L&I
WA
05
—
6010938
—
WA
01
—
91-1996749
TAX ID
WA
Enumeration date
08/04/2006
Last updated
11/29/2017
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