Provider Demographics
NPI:1578934733
Name:SON, MATTHEW RICHARDS (PHARMD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:RICHARDS
Last Name:SON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2324 EASTLAKE AVE E
Mailing Address - Street 2:#400
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3345
Mailing Address - Country:US
Mailing Address - Phone:206-838-4590
Mailing Address - Fax:206-838-4599
Practice Address - Street 1:2324 EASTLAKE AVE E
Practice Address - Street 2:#400
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3345
Practice Address - Country:US
Practice Address - Phone:206-838-4590
Practice Address - Fax:206-838-4599
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60574882183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist