Provider Demographics
NPI:1003893777
Name:EATON, WILLIAM D (RPH)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:D
Last Name:EATON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13529 25TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-3407
Mailing Address - Country:US
Mailing Address - Phone:206-362-6651
Mailing Address - Fax:
Practice Address - Street 1:1628 5TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1606
Practice Address - Country:US
Practice Address - Phone:206-622-0582
Practice Address - Fax:206-343-2328
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP10629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist