Individual
MR. AMPHORN HOSAKUL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1959 NE PACIFIC ST, BOX 356015, SEATTLE, WA 98195
(206) 598-6060
(206) 598-6058
Mailing address
2029A MINOR AVE E, SEATTLE, WA 98102-3513
(206) 598-6058
(206) 598-3808
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
PH00017630
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH00017630
WASHIGNTON STATE PHARMACIST LICENSE
WA
Enumeration date
09/26/2012
Last updated
09/26/2012
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