Provider Demographics
NPI:1497270003
Name:BOONE, PHILIP ANTHONY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:ANTHONY
Last Name:BOONE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:PHILIP
Other - Middle Name:ANTHONY
Other - Last Name:BOONE
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1660 S COLUMBIAN WAY
Mailing Address - Street 2:S-119
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-1532
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1660 S COLUMBIAN WAY
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?:No
Enumeration Date:2017-08-04
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60762745183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist