Provider Demographics
NPI:1578939302
Name:WALGREEN
Entity Type:Organization
Organization Name:WALGREEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MESAY
Authorized Official - Middle Name:ENDALE
Authorized Official - Last Name:JIMMAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-302-1509
Mailing Address - Street 1:15220 156TH NE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007
Mailing Address - Country:US
Mailing Address - Phone:206-302-1509
Mailing Address - Fax:
Practice Address - Street 1:15220 156TH NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007
Practice Address - Country:US
Practice Address - Phone:206-302-1509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-17
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty