Provider Demographics
NPI:1598970584
Name:MATSUWAKA, EDWARD K (RPH)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:K
Last Name:MATSUWAKA
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 1:720 7TH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-1957
Mailing Address - Country:US
Mailing Address - Phone:206-838-6070
Mailing Address - Fax:206-838-9775
Practice Address - Street 1:720 7TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1957
Practice Address - Country:US
Practice Address - Phone:206-838-6070
Practice Address - Fax:206-838-9775
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA14541183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist