Provider Demographics
NPI:1578548913
Name:STEINER, CARROLL RAY (RPH)
Entity Type:Individual
Prefix:MR
First Name:CARROLL
Middle Name:RAY
Last Name:STEINER
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 1:6813 86TH ST E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98371-6449
Mailing Address - Country:US
Mailing Address - Phone:253-848-1239
Mailing Address - Fax:253-848-4501
Practice Address - Street 1:6720 E GREEN LAKE WAY N
Practice Address - Street 2:THE HEARTHSTONE
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-5439
Practice Address - Country:US
Practice Address - Phone:206-525-9666
Practice Address - Fax:206-522-0190
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00007146183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist