Provider Demographics
NPI:1689675951
Name:MOLITOR, RICHARD EDWARD JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:EDWARD
Last Name:MOLITOR
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16239 119TH PL NE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-6494
Mailing Address - Country:US
Mailing Address - Phone:425-481-0472
Mailing Address - Fax:425-899-2795
Practice Address - Street 1:12303 NE 130TH LN
Practice Address - Street 2:#210
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3099
Practice Address - Country:US
Practice Address - Phone:425-899-2792
Practice Address - Fax:425-899-2795
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00011393183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist