1164612271 NPI number — MRS. DOROTHY ANN WEINBERG RPH

Table of content: MRS. DOROTHY ANN WEINBERG RPH (NPI 1164612271)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164612271 NPI number — MRS. DOROTHY ANN WEINBERG RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEINBERG
Provider First Name:
DOROTHY
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MICHELBACH
Provider Other First Name:
DOROTHY
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
RPH
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1164612271
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/26/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2826 140TH AVE NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLEVUE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98005-1827
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-881-1667
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4727 DENVER AVENUE SOUTH
Provider Second Line Business Practice Location Address:
BARTELL DRUGS
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98134-2316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-763-2626
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/26/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  PH00007964 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 183500000X , with the licence number: 3366 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)