Provider Demographics
NPI:1619055852
Name:BARRY LAFFERTY'S PRESCRIPTION PHARMACY
Entity Type:Organization
Organization Name:BARRY LAFFERTY'S PRESCRIPTION PHARMACY
Other - Org Name:LAFFERTY'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:LAFFERTY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:206-783-5133
Mailing Address - Street 1:5312 17TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3815
Mailing Address - Country:US
Mailing Address - Phone:206-783-5133
Mailing Address - Fax:
Practice Address - Street 1:5312 17TH AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3815
Practice Address - Country:US
Practice Address - Phone:206-783-5133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACF000004613336C0003X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Not Answered3336S0011XSuppliersPharmacySpecialty Pharmacy