1588033237 NPI number — MRS. CHRISTINE MARIE KINCH PHARMD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588033237 NPI number — MRS. CHRISTINE MARIE KINCH PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KINCH
Provider First Name:
CHRISTINE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MUNN
Provider Other First Name:
CHRISTINE
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARMD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1588033237
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/23/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9601 STEILACOOM BLVD SW
Provider Second Line Business Mailing Address:
PHARMACY AA3
Provider Business Mailing Address City Name:
LAKEWOOD
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98498-7212
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-756-2521
Provider Business Mailing Address Fax Number:
253-756-2707

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9601 STEILACOOM BLVD SW
Provider Second Line Business Practice Location Address:
PHARMACY AA3
Provider Business Practice Location Address City Name:
LAKEWOOD
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98498-7212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-756-2521
Provider Business Practice Location Address Fax Number:
253-756-2707
Provider Enumeration Date:
09/23/2015

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:  PH60215893 , 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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