Provider Demographics
NPI:1063493773
Name:HUMPHREYS, SOPHIA Z (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SOPHIA
Middle Name:Z
Last Name:HUMPHREYS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15230 15TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98155
Mailing Address - Country:US
Mailing Address - Phone:206-361-3565
Mailing Address - Fax:206-361-3157
Practice Address - Street 1:15230 15TH AVE NE
Practice Address - Street 2:FIRCREST RHC PHARMACY DEPARTMENT
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-7130
Practice Address - Country:US
Practice Address - Phone:206-361-3565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00022476183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist