Provider Demographics
NPI:1225330723
Name:KIRBY, JANICE (RPH)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:KIRBY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7303 6TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-4942
Mailing Address - Country:US
Mailing Address - Phone:206-789-0849
Mailing Address - Fax:
Practice Address - Street 1:138 SW 148TH ST
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-1924
Practice Address - Country:US
Practice Address - Phone:206-243-2796
Practice Address - Fax:206-248-8361
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 00010355183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist