Provider Demographics
NPI:1235232265
Name:KUNIYOSHI, DEREK YUKIO (PHARM D,)
Entity Type:Individual
Prefix:
First Name:DEREK
Middle Name:YUKIO
Last Name:KUNIYOSHI
Suffix:
Gender:M
Credentials:PHARM D,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 VINE ST APT 515
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-1591
Mailing Address - Country:US
Mailing Address - Phone:206-853-5864
Mailing Address - Fax:
Practice Address - Street 1:1660 S COLUMBIAN WAY # S-119-PHAR
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1532
Practice Address - Country:US
Practice Address - Phone:206-277-1963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00066151183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist