Provider Demographics
NPI:1306193255
Name:VOLODARSKY, RAISA R (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:RAISA
Middle Name:R
Last Name:VOLODARSKY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 106TH AVE NE
Mailing Address - Street 2:APT. A107
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4673
Mailing Address - Country:US
Mailing Address - Phone:718-916-3330
Mailing Address - Fax:
Practice Address - Street 1:1135 116TH AVE NE
Practice Address - Street 2:SUITE#105
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4623
Practice Address - Country:US
Practice Address - Phone:425-453-1130
Practice Address - Fax:425-453-5985
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60445629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist