Provider Demographics
NPI:1174824957
Name:COCHRAN, STEPHEN M (RPH)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:M
Last Name:COCHRAN
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 1:1645 140TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2320
Mailing Address - Country:US
Mailing Address - Phone:425-643-1778
Mailing Address - Fax:425-643-1816
Practice Address - Street 1:1645 140TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2320
Practice Address - Country:US
Practice Address - Phone:425-643-1778
Practice Address - Fax:425-643-1816
Is Sole Proprietor?:No
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA9890183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist