National Provider Identifier Database

COUNTRY DOCTOR COMMUNITY CLINIC
Clinic Pharmacy

A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.


Contact Information

COUNTRY DOCTOR COMMUNITY CLINIC
510 19TH AVE E
SEATTLE, WA98112-4095
Phone: 206-709-7116
Fax: 206-299-1608
Website:
Specialty Taxonomy Code
* Clinic Pharmacy 3336C0002X

* Indicates primary specialty

NPI Profile & details for COUNTRY DOCTOR COMMUNITY CLINIC

NPI Number 1639390982
Legal business name
LBN
COUNTRY DOCTOR COMMUNITY CLINIC
Authorized official MARIA SAUCEDO - (CREDENTIALING SPECIALIST)
Entity Organization
Organization subpart No
Enumeration date 05/02/2007
Last updated 01/26/2024 - About 2 years ago
Sole proprietor1 Not specified
Identifiers
  • WA License #: CF00004729
  • WA Other: PHAR.CF.61403411 LICENSE NUMBER

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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