Organization
TULALIP CLINICAL PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELVIN LEE (PHARMACY DIRECTOR)
(360) 716-2660
Entity
Organization
Contact information
Practice address
8825 34TH AVE NE, SUITE A, QUIL CEDA VILLAGE, WA 98271-8085
(360) 716-2660
Mailing address
8825 34TH AVE NE, SUITE A, QUIL CEDA VILLAGE, WA 98271-8085
(360) 716-2660
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.00055944
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6019939
—
WA
Enumeration date
05/03/2017
Last updated
05/03/2017
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