1881978765 NPI number — DR. RACHEL CHANTRY WAITE KRISLOCK PHARM.D.

Table of content: VICTORIA LYNN WINKELBAUER (NPI 1851996045)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881978765 NPI number — DR. RACHEL CHANTRY WAITE KRISLOCK PHARM.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KRISLOCK
Provider First Name:
RACHEL
Provider Middle Name:
CHANTRY WAITE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARM.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WAITE
Provider Other First Name:
RACHEL
Provider Other Middle Name:
CHANTRY
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHARM.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1881978765
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/16/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1100 9TH AVE
Provider Second Line Business Mailing Address:
MAIL STOP: H3-PL
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98111
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-223-6852
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 9TH AVE MAIL STOP H3-PL
Provider Second Line Business Practice Location Address:
VIRGINIA MASON MEDICAL CENTER
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-223-6852
Provider Business Practice Location Address Fax Number:
206-341-0867
Provider Enumeration Date:
10/10/2011

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:  PH60228192 , 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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