Provider Demographics
NPI:1194028753
Name:DOTY, GEORGE ALPHONSE (RPH)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:ALPHONSE
Last Name:DOTY
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 1:24008 SNO WOOD RD
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-9743
Mailing Address - Country:US
Mailing Address - Phone:425-806-7728
Mailing Address - Fax:425-806-7725
Practice Address - Street 1:24008 SNO WOOD RD
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-9743
Practice Address - Country:US
Practice Address - Phone:425-806-7728
Practice Address - Fax:425-806-7725
Is Sole Proprietor?:No
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00009528183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist