Provider Demographics
NPI:1073275301
Name:CUNNINGHAM, ROBERT JONES (RPH)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JONES
Last Name:CUNNINGHAM
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 1:16956 SE 183RD PL
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-8812
Mailing Address - Country:US
Mailing Address - Phone:425-301-7541
Mailing Address - Fax:
Practice Address - Street 1:17254 140TH AVE SE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-7014
Practice Address - Country:US
Practice Address - Phone:425-226-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-13
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61188214183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist