1720046568 NPI number — MRS. CARREN DIANE DONATI PHARMACY TECHNICIAN

Table of content: MRS. CARREN DIANE DONATI PHARMACY TECHNICIAN (NPI 1720046568)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720046568 NPI number — MRS. CARREN DIANE DONATI PHARMACY TECHNICIAN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DONATI
Provider First Name:
CARREN
Provider Middle Name:
DIANE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PHARMACY TECHNICIAN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720046568
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17637 162ND PL SE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RENTON
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98058-9162
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-271-1555
Provider Business Mailing Address Fax Number:
425-204-9736

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17254 140TH AVE SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RENTON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98058-7014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-226-7000
Provider Business Practice Location Address Fax Number:
425-235-8796
Provider Enumeration Date:
05/02/2006

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: 183700000X , with the licence number:  VA00045631 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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