Provider Demographics
NPI:1659149904
Name:VETH, UDDOM (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:UDDOM
Middle Name:
Last Name:VETH
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 1:207 MERIDIAN AVE E APT F307
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98371-1063
Mailing Address - Country:US
Mailing Address - Phone:206-697-7990
Mailing Address - Fax:
Practice Address - Street 1:802 134TH ST SW
Practice Address - Street 2:BUILDING C SUITE 140
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204
Practice Address - Country:US
Practice Address - Phone:800-607-6861
Practice Address - Fax:800-633-0334
Is Sole Proprietor?:No
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61216633183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist