Provider Demographics
NPI:1447235569
Name:HAMPTON, MARY KAY (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:KAY
Last Name:HAMPTON
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 1:27327 NE BIG ROCK RD
Mailing Address - Street 2:
Mailing Address - City:DUVALL
Mailing Address - State:WA
Mailing Address - Zip Code:98019-8206
Mailing Address - Country:US
Mailing Address - Phone:425-788-1274
Mailing Address - Fax:
Practice Address - Street 1:6619 132ND AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-8627
Practice Address - Country:US
Practice Address - Phone:425-881-5544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00039331183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist