Provider Demographics
NPI:1558514851
Name:LIVINGSTONE, JAMES BRADLEY (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:BRADLEY
Last Name:LIVINGSTONE
Suffix:
Gender:M
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:PO BOX 12956
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98508-2956
Mailing Address - Country:US
Mailing Address - Phone:360-280-5546
Mailing Address - Fax:
Practice Address - Street 1:1908 4TH AVE E
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-4632
Practice Address - Country:US
Practice Address - Phone:360-352-4426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA19516183500000X
WI14617183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist