Organization
QFC
Active
Organization
QFC
Active
Parent organization
KROGER
Organization subpart
Yes
Provider details
NPI number
Legal business name
KROGER
Authorized official
SUSAN ELISE GUNN RPH (PHARMACIST)
(425) 869-7474
Entity
Organization
Contact information
Practice address
8867 161ST AVE NE, REDMOND, WA 98052-3585
(425) 869-7474
(425) 869-0580
Mailing address
8867 161ST AVE NE, REDMOND, WA 98052-3585
(425) 869-7474
(425) 869-0580
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PH00010787
WA
Other
Enumeration date
08/26/2012
Last updated
08/26/2012
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